Cu-Uvin S, Caliendo A M, Reinert S, Chang A, Juliano-Remollino C, Flanigan T P, Mayer K H, Carpenter C C
Brown University, Providence, RI, USA.
AIDS. 2000 Mar 10;14(4):415-21. doi: 10.1097/00002030-200003100-00015.
To determine the frequency of cervicovaginal lavage and plasma HIV-1 RNA levels that are below detectable levels (< 400 copies/ml) among women on highly active antiretroviral therapy (HAART), non-HAART and on no therapy. To compare the effect of initiating HAART on the timing of HIV-1 RNA suppression in the blood plasma and genital tract among antiretroviral-naïve women.
Data were obtained from 205 HIV-infected women with paired plasma and cervicovaginal lavage viral load measurements. Seven antiretroviral-naïve women starting HAART had viral load measurements performed daily for one week, at 2 weeks and at 1 month after initiating therapy. Viral load quantification was carried out by nucleic acid sequence-based amplification assay. The lower limit of detection was 400 copies/ml.
Plasma and cervicovaginal HIV-1 RNA was detectable in 71 and 26% of the women, respectively. Among women with plasma viral loads less than 400, 400-9999, and 10,000 copies/ml or over, genital tract HIV-1 RNA was detected in 3, 17 and 48%, respectively (P < 0.001). Fifty-one per cent of the women with CD4 cell counts of less than 200/mm3 had detectable cervicovaginal viral loads compared with 18% among women with CD4 cell counts of 200/mm3 or over (P < 0.001). Cervicovaginal HIV-1 RNA was less than 400 copies/ml in 85% of those on HAART, 69% of those on non-HAART and 69% of those on no therapy (P < 0.045). In seven antiretroviral-naïve women initiating HAART, cervicovaginal HIV-1 RNA decreased by 0.7-2.1 log10 within 1-14 days of starting therapy.
The cervicovaginal HIV-1 RNA level was positively correlated with plasma HIV-1 RNA and negatively with the CD4 cell count. The use of HAART was significantly associated with below-detectable levels of HIV-1 RNA in both plasma and the genital tract. HIV-1 RNA suppression in the genital tract may occur rapidly after initiating therapy.
确定接受高效抗逆转录病毒治疗（HAART）、未接受HAART以及未接受任何治疗的女性中，宫颈阴道灌洗和血浆中HIV-1 RNA水平低于可检测水平（<400拷贝/毫升）的频率。比较开始HAART对初治抗逆转录病毒治疗女性血浆和生殖道中HIV-1 RNA抑制时间的影响。
数据来自205名HIV感染女性，她们同时进行了血浆和宫颈阴道灌洗病毒载量检测。7名开始HAART的初治抗逆转录病毒治疗女性在开始治疗后的一周内每天进行病毒载量检测，在第2周和第1个月时也进行检测。病毒载量定量通过基于核酸序列的扩增试验进行。检测下限为400拷贝/毫升。
分别有71%和26%的女性血浆和宫颈阴道中可检测到HIV-1 RNA。在血浆病毒载量低于400、400 - 9999以及10000拷贝/毫升或更高的女性中，生殖道中检测到HIV-1 RNA的比例分别为3%、17%和48%（P<0.001）。CD4细胞计数低于200/mm3的女性中，51%的宫颈阴道病毒载量可检测到，而CD4细胞计数为200/mm3或更高的女性中这一比例为18%（P<0.001）。接受HAART的女性中85%的宫颈阴道HIV-1 RNA低于400拷贝/毫升，未接受HAART的女性中这一比例为69%，未接受任何治疗的女性中这一比例为69%（P<0.045）。在7名开始HAART的初治抗逆转录病毒治疗女性中，宫颈阴道HIV-1 RNA在开始治疗后的1 - 14天内下降了0.7 - 2.1 log10。
宫颈阴道HIV-1 RNA水平与血浆HIV-1 RNA呈正相关，与CD4细胞计数呈负相关。使用HAART与血浆和生殖道中HIV-1 RNA低于可检测水平显著相关。开始治疗后，生殖道中的HIV-1 RNA可能迅速受到抑制。
