一项关于 depot 型醋酸甲羟孕酮对开始和继续接受抗逆转录病毒治疗的女性血浆和宫颈 HIV-1 检测影响的前瞻性队列研究。
A prospective cohort study of the effect of depot medroxyprogesterone acetate on detection of plasma and cervical HIV-1 in women initiating and continuing antiretroviral therapy.
机构信息
*Department of Medicine, University of Washington, Seattle, WA; †Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya; Departments of ‡Epidemiology; §Biostatistics; ‖Global Health, University of Washington, Seattle WA; ¶Fred Hutchinson Cancer Research Center, Seattle, WA; #Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya; and **Pathcare Laboratories, Mombasa, Kenya.
出版信息
J Acquir Immune Defic Syndr. 2014 Aug 1;66(4):452-6. doi: 10.1097/QAI.0000000000000187.
Abstract
Depot medroxyprogesterone acetate (DMPA) use among HIV-1-infected women may increase transmission by increasing plasma and genital HIV-1 RNA shedding. We investigated associations between DMPA use and HIV-1 RNA in plasma and cervical secretions. One hundred two women initiated antiretroviral therapy, contributing 925 follow-up visits over a median of 34 months. Compared with visits with no hormonal contraception exposure, DMPA exposure did not increase detection of plasma (adjusted odds ratio: 0.81, 95% confidence interval: 0.47 to 1.39) or cervical HIV-1 RNA (adjusted odds ratio: 1.41, 95% confidence interval: 0.54 to 3.67). Our results suggest that DMPA is unlikely to increase infectivity in HIV-positive women who are adherent to effective antiretroviral therapy.
摘要
HIV-1 感染妇女使用 depot 醋酸甲羟孕酮（DMPA）可能会增加血浆和生殖器 HIV-1 RNA 的脱落，从而增加传播风险。我们研究了 DMPA 使用与血浆和宫颈分泌物中 HIV-1 RNA 之间的关联。102 名妇女开始接受抗逆转录病毒治疗，在中位数为 34 个月的随访中提供了 925 次就诊。与没有激素避孕暴露的就诊相比，DMPA 暴露并未增加血浆中 HIV-1 RNA 的检出率（调整后的优势比：0.81，95%置信区间：0.47 至 1.39）或宫颈 HIV-1 RNA 的检出率（调整后的优势比：1.41，95%置信区间：0.54 至 3.67）。我们的结果表明，对于坚持有效抗逆转录病毒治疗的 HIV 阳性妇女，DMPA 不太可能增加传染性。
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