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https://www.arca.fiocruz.br/handle/icict/29845
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2023-01-01
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- INI - Artigos de Periódicos [3397]
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CHANGES IN HIV-1 SUBTYPES B AND C GENITAL TRACT RNA IN WOMEN AND MEN AFTER INITIATION OF ANTIRETROVIRAL THERAPY
Author
Affilliation
University of North Carolina. Chapel Hill, NC, USA.
Brown University. Providence, RI, USA.
Harvard School of Public Health. Boston, MA, USA.
Harvard School of Public Health. Boston, MA, USA.
Harvard School of Public Health. Boston, MA, USA.
UNC Project. Lilongwe, Malawi.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
University of Witwatersrand. Johannesburg, South Africa.
University of Washington. Seattle, WA, USA.
University of Washington. Seattle, WA, USA.
Frontier Science and Research Technology Foundation. Amherst, NY, USA.
Social and Scientific Systems. Silver Spring, MD, USA.
University of Zimbabwe. Harare, Zimbabwe.
Brown University. Providence, RI, USA.
YRG Centre for AIDS Research. Chennai, India.
University of Colorado. Denver, Aurora, CO, USA.
Brown University. Providence, RI, USA.
Harvard School of Public Health. Boston, MA, USA.
Harvard School of Public Health. Boston, MA, USA.
Harvard School of Public Health. Boston, MA, USA.
UNC Project. Lilongwe, Malawi.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
University of Witwatersrand. Johannesburg, South Africa.
University of Washington. Seattle, WA, USA.
University of Washington. Seattle, WA, USA.
Frontier Science and Research Technology Foundation. Amherst, NY, USA.
Social and Scientific Systems. Silver Spring, MD, USA.
University of Zimbabwe. Harare, Zimbabwe.
Brown University. Providence, RI, USA.
YRG Centre for AIDS Research. Chennai, India.
University of Colorado. Denver, Aurora, CO, USA.
Abstract
BACKGROUND: Combination antiretroviral therapy (cART) reduces genital tract human immunodeficiency virus type 1 (HIV-1) load and reduces the risk of sexual transmission, but little is known about the efficacy of cART for decreasing genital tract viral load (GTVL) and differences in sex or HIV-1 subtype. METHODS: HIV-1 RNA from blood plasma, seminal plasma, or cervical wicks was quantified at baseline and at weeks 48 and 96 after entry in a randomized clinical trial of 3 cART regimens. RESULTS: One hundred fifty-eight men and 170 women from 7 countries were studied (men: 55% subtype B and 45% subtype C; women: 24% subtype B and 76% subtype C). Despite similar baseline CD4(+) cell counts and blood plasma viral loads, women with subtype C had the highest GTVL (median, 5.1 log10 copies/mL) compared to women with subtype B and men with subtype C or B (4.0, 4.0, and 3.8 log10 copies/mL, respectively; P < .001). The proportion of participants with a GTVL below the lower limit of quantification (LLQ) at week 48 (90%) and week 96 (90%) was increased compared to baseline (16%; P < .001 at both times). Women were significantly less likely to have GTVL below the LLQ compared to men (84% vs 94% at week 48, P = .006; 84% vs 97% at week 96, P = .002), despite a more sensitive assay for seminal plasma than for cervical wicks. No difference in GTVL response across the 3 cART regimens was detected. CONCLUSIONS: The female genital tract may serve as a reservoir of persistent HIV-1 replication during cART and affect the use of cART to prevent sexual and perinatal transmission of HIV-1.
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