title: Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding.
abstract: HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher's exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman's rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling.
authors.affiliation: 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, GA, USA.|2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Janet M
authors.initials: JM
authors.lastname: McNicholl
authors.affiliation: 2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Wanna
authors.initials: W
authors.lastname: Leelawiwat
authors.affiliation: 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, GA, USA.|2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Sara
authors.initials: S
authors.lastname: Whitehead
authors.affiliation: 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, GA, USA.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Hanson
authors.affiliation: 1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, GA, USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Evans-Strickfaden
authors.affiliation: 3 Division of STD Prevention, Centers for Disease Control and Prevention, GA, USA.
authors.forename: Chen Y
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: 2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Wannee
authors.initials: W
authors.lastname: Chonwattana
authors.affiliation: 2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Famui
authors.initials: F
authors.lastname: Mueanpai
authors.affiliation: 2 The Thai Ministry of Public Health, U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand.
authors.forename: Chonticha
authors.initials: C
authors.lastname: Kittinunvorakoon
authors.affiliation: 3 Division of STD Prevention, Centers for Disease Control and Prevention, GA, USA.
authors.forename: Lauri
authors.initials: L
authors.lastname: Markowitz
authors.affiliation: 3 Division of STD Prevention, Centers for Disease Control and Prevention, GA, USA.
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Dunne
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006558:Herpes Genitalis / Q000188:drug therapy* / Q000635:transmission / Q000821:virology; D018258:Herpesvirus 2, Human / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D007507:Therapeutic Irrigation; D019562:Viral Load; D017201:Virus Shedding / Q000187:drug effects
chemical_list: D044966:Anti-Retroviral Agents; D000998:Antiviral Agents; D000212:Acyclovir
keywords: Virus; ano-genital; polymerase chain reaction; sampling; self-collection; sexually transmitted infection; transmission