测量女性生殖道分泌物中HIV RNA病毒载量的采样方法比较。
Comparison of sampling methods to measure HIV RNA viral load in female genital tract secretions.
作者信息
Jaumdally Shameem Z, Jones Heidi E, Hoover Donald R, Gamieldien Hoyam, Kriek Jean-Mari, Langwenya Nontokozo, Myer Landon, Passmore Jo-Ann S, Todd Catherine S
机构信息
Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Department of Epidemiology and Biostatistics, City University of New York Graduate School of Public Health & Health Policy, New York, NY, USA.
出版信息
Am J Reprod Immunol. 2017 Mar;77(3). doi: 10.1111/aji.12619. Epub 2017 Jan 23.
PROBLEM
How does menstrual cup (MC) compare to other genital sampling methods for HIV RNA recovery?
METHOD OF STUDY
We compared HIV RNA levels between MC, endocervical swab (ECS), and ECS-enriched cervicovaginal lavage (eCVL) specimens in 51 HIV-positive, antiretroviral therapy-naive women at enrollment, 3 and 6 months, with order rotated by visit. Paired comparisons were analyzed with McNemar's exact tests, signed-rank tests, and an extension of Somer's D for pooled analyses across visits.
RESULTS
MC specimens had the highest proportion of quantifiable HIV VL at enrollment and month 3, but more MC specimens (n=12.8%) were insufficient for testing, compared with ECS (2%, P=0.006) and eCVL (0%, P<0.001). Among sufficient specimens, median VL was significantly higher for MC (2.62 log copies/mL) compared to ECS (1.30 log copies/mL, P<0.001) and eCVL (1.60 log copies/mL, P<0.001) across visits.
CONCLUSION
MC may be more sensitive than eCVL and CVS, provided insufficient specimens are reduced.
问题
与其他生殖器采样方法相比，月经杯（MC）在HIV RNA检测方面表现如何？
研究方法
我们比较了51名未接受抗逆转录病毒治疗的HIV阳性女性在入组时、3个月和6个月时，月经杯（MC）、宫颈拭子（ECS）和富集宫颈阴道灌洗（eCVL）标本中的HIV RNA水平，每次访视时顺序轮换。配对比较采用McNemar精确检验、符号秩检验以及Somer's D的扩展方法进行汇总分析。
结果
在入组时和第3个月，MC标本中可检测到HIV病毒载量（VL）的比例最高，但与ECS（2%，P=0.006）和eCVL（0%，P<0.001）相比，MC标本中无法检测的比例更高（n=12.8%）。在足够的标本中，MC的VL中位数（2.62 log拷贝/mL）显著高于ECS（1.30 log拷贝/mL，P<0.001）和eCVL（1.60 log拷贝/mL，P<0.001）。
结论
如果减少不合格标本，MC可能比eCVL和宫颈阴道采样（CVS）更敏感。
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