title: Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells.
abstract: BACKGROUND
  Depot medroxyprogesterone acetate (DMPA) has been linked to human immunodeficiency virus type 1 (HIV-1) acquisition.
  
  
  METHODS
  Vaginal microbiota of women using DMPA for up to 2 years were cultured. Mucosal immune cell populations were measured by immunohistological staining.
  
  
  RESULTS
  Over 12 months, the proportion with H2O2-positive lactobacilli decreased (n = 32; 53% vs 27%; P = .03). Median vaginal CD3(+) cells also decreased (n = 15; 355 vs 237 cells/mm(2); P = .03), as did CD3(+)CCR5(+) cells (195 vs 128 cells/mm(2); P = .04), HLA-DR(+) cells (130 vs 96 cells/mm(2); P = .27), and HLA-DR(+)CCR5(+) cells (18 vs 10 cells/mm(2); P = .33).
  
  
  CONCLUSIONS
  DMPA contraception does not increase vaginal mucosal CCR5(+) HIV target cells but does decrease CD3(+) T lymphocytes and vaginal H2O2-producing lactobacilli.
authors.affiliation: Department of Obstetrics and Gynecology Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Mitchell
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Leslie
authors.initials: L
authors.lastname: McLemore
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Katharine
authors.initials: K
authors.lastname: Westerberg
authors.affiliation: Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: Rena
authors.initials: R
authors.lastname: Astronomo
authors.affiliation: Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Smythe
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gardella
authors.affiliation: Department of Internal Medicine II, University Hospital, Regensburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Mack
authors.affiliation: Department of Laboratory Medicine Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: Amalia
authors.initials: A
authors.lastname: Magaret
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Patton
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Kathy
authors.initials: K
authors.lastname: Agnew
authors.affiliation: Department of Laboratory Medicine Department of Medicine, Division of Allergy and Infectious Diseases Department of Global Health, University of Washington Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: M Juliana
authors.initials: MJ
authors.lastname: McElrath
authors.affiliation: Department of Obstetrics and Gynecology Department of Medicine, Division of Allergy and Infectious Diseases Fred Hutchinson Cancer Research Center, Vaccine and Infectious Diseases Division, Seattle, Washington.
authors.forename: Florian
authors.initials: F
authors.lastname: Hladik
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: David
authors.initials: D
authors.lastname: Eschenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use; D004343:Drug Implants; D004848:Epithelium / Q000187:drug effects / Q000276:immunology / Q000382:microbiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects*; D064307:Microbiota / Q000187:drug effects* / Q000276:immunology; D009092:Mucous Membrane / Q000187:drug effects / Q000276:immunology / Q000821:virology; D014621:Vagina / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology* / Q000821:virology; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D004343:Drug Implants; D017258:Medroxyprogesterone Acetate
keywords: HIV; medroxyprogesterone acetate; vaginal mucosa