Achilles Sharon L, Creinin Mitchell D, Stoner Kevin A, Chen Beatrice A, Meyn Leslie, Hillier Sharon L
Magee-Womens Research Institute, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Magee-Womens Research Institute, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
Am J Obstet Gynecol. 2014 Nov;211(5):489.e1-9. doi: 10.1016/j.ajog.2014.05.016. Epub 2014 May 13.
The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.
Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.
Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.
Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.
人类免疫缺陷病毒（HIV）在生殖道感染的主要靶细胞是表面表达CCR5的CD4 T细胞。生殖道中表达CCR5的T细胞的改变可能会影响HIV感染风险。我们假设，与基线相比，使用激素宫内节育器（IUD）比非激素IUD更能改变女性生殖道中的HIV靶细胞（主要是CCR5 + CD4细胞）。
34名年龄在18 - 40岁、寻求IUD避孕的健康HIV阴性女性被随机分配接受左炔诺孕酮IUD或铜T380A IUD。还纳入了一组8名不需要避孕的对照女性。通过宫颈细胞刷和子宫内膜活检在放置IUD前和放置后2个月收集生殖道黏膜免疫细胞群体，并通过流式细胞术进行分析。使用配对学生t检验评估从基线到随访检查细胞数量和表达受体百分比的平均差异。
两种IUD均未改变上、下生殖道内T细胞的数量。与基线相比，使用左炔诺孕酮IUD 2个月后，使用者子宫内膜和宫颈中表达HIV共受体CCR5的T细胞数量减少。与基线相比，使用IUD 2个月后，左炔诺孕酮IUD使用者的活化子宫内膜T细胞减少，铜IUD使用者的活化宫颈T细胞减少。
与放置IUD前相比，使用IUD的女性子宫内膜和宫颈T细胞上CCR5 HIV共受体的表达降低。这些发现表明，使用IUD不会增加HIV感染易感性。
