title: Is there an association between HIV-1 genital shedding and cervical intraepithelial neoplasia 2/3 among women on antiretroviral therapy?
abstract: OBJECTIVE
  Given the high prevalence of cervical intraepithelial neoplasia (CIN) grade 2/3 among HIV-infected women, we sought to examine the relationship between CIN 2/3 and HIV-1 genital shedding among women on highly active antiretroviral therapy (HAART).
  
  
  METHODS
  Paired plasma and cervical wick specimens for HIV-1 RNA measurements were obtained from 44 HIV-infected women with biopsy-confirmed CIN 2/3 (cases) and 44 age-matched HIV-infected women with normal cervical findings on colposcopy (controls). All subjects tested negative for sexually transmitted infections and had been stable on HAART for at least 3 months. HIV-1 viral load was measured in both blood and cervical specimens using commercial real-time polymerase chain reaction assays.
  
  
  RESULTS
  Cervical intraepithelial neoplasia 2/3 was not significantly associated with the detection or magnitude of plasma or cervical HIV-1 RNA shedding. HIV was detected in the plasma in 10 cases (23%) and 10 controls (25%) (odds ratio = 1.0; 95% confidence interval = 0.33-3.1). Cervical HIV-1 was detected in 6 cases (13.6%) and 9 controls (20.4%) (odds ratio = 0.61; 95% confidence interval = 0.20-1.90). Mean HIV-1 concentration in cervical secretions among women with CIN 2/3 who shed was 2.93 log10 copies versus 2.72 among controls (p = .65).
  
  
  CONCLUSIONS
  Among women on HAART, we found no relationship between CIN 2/3 and HIV-1 genital shedding.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Services, University of California, San Francisco, San Franciso, CA 94105, USA.
authors.forename: Megan Justine
authors.initials: MJ
authors.lastname: Huchko
authors.forename: Victoria
authors.initials: V
authors.lastname: Woo
authors.forename: Teri
authors.initials: T
authors.lastname: Liegler
authors.forename: Anna
authors.initials: A
authors.lastname: Leddy
authors.forename: Karen
authors.initials: K
authors.lastname: Smith-McCune
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bukusi
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D017201:Virus Shedding; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*
chemical_list: D012367:RNA, Viral