Fiore Josè Ramòn, Suligoi Barbara, Saracino Annalisa, Di Stefano Mariantonietta, Bugarini Roberto, Lepera Achiropita, Favia Anna, Monno Laura, Angarano Gioacchino, Pastore Giuseppe
Clinic of Infectious Diseases, University of Bari, Italy.
AIDS. 2003 Oct 17;17(15):2169-76. doi: 10.1097/00002030-200310170-00004.
To evaluate the determinants of HIV-1 RNA shedding in cervicovaginal secretions and the effects of antiretroviral therapy in a group of infected women.
A total of 122 women from whom paired peripheral blood and cervicovaginal lavage samples were available were enrolled in the study. HIV-1 RNA was quantified in the plasma and cell-free fraction of cervicovaginal lavages by the nucleic acid sequence-based amplification assay (lower limit of detection 80 copies/ml).
Seventy-one per cent of the women had detectable viral load in the cervicovaginal lavage and this appeared to be correlated to plasma viral load and to the degree of immunodeficiency as expressed by the absolute number of CD4 cells. Antiretroviral-treated patients had a lower risk of shedding the virus in the genital tract, but this association was limited to patients treated with highly active antiretroviral therapy (HAART). However, in 25% of women with undetectable plasma viral load, a genital shedding of the virus was demonstrated.
Plasma viral load may fail as a marker of infectivity of genital secretions. HAART treatment seems to be more efficacious in suppressing viral shedding at the genital level. The female genital tract represents a distinct compartment for HIV-1 replication/evolution.
评估一组感染女性宫颈阴道分泌物中HIV-1 RNA排出的决定因素以及抗逆转录病毒疗法的效果。
共有122名可提供配对外周血和宫颈阴道灌洗样本的女性纳入本研究。采用基于核酸序列的扩增检测法（检测下限为80拷贝/毫升）对血浆和宫颈阴道灌洗的无细胞部分中的HIV-1 RNA进行定量。
71%的女性宫颈阴道灌洗中可检测到病毒载量，这似乎与血浆病毒载量以及以CD4细胞绝对数表示的免疫缺陷程度相关。接受抗逆转录病毒治疗的患者在生殖道排出病毒的风险较低，但这种关联仅限于接受高效抗逆转录病毒治疗（HAART）的患者。然而，在25%血浆病毒载量检测不到的女性中，证实存在病毒的生殖道排出。
血浆病毒载量可能无法作为生殖器分泌物传染性的标志物。HAART治疗在抑制生殖器水平的病毒排出方面似乎更有效。女性生殖道是HIV-1复制/进化的一个独特部位。
