Factors associated with nucleic acids related to human immunodeficiency virus type 1 in cervico-vaginal secretions

Arsenio Spinillo, Maurizia Debiaggi, Francesca Zara, Renato Maserati, Franco Polatti, Antonella De Santolo

Research output: Contribution to journalArticle

Abstract

Objective: To assess HIV-related nucleic acids in cervico-vaginal secretions and the factors associated with them. Design: Observational study. Setting: Department of Obstetrics and Gynaecology, University of Pavia, Italy. Population: HIV-positive patients attending a cytology service. Methods: Paired blood and cervico-vaginal lavage samples were obtained from 122 known HIV-seropositive patients during periodic visits for cytologic screening for lower genital tract neoplasia. Vaginal specimens for the diagnosis of bacterial vaginosis, trichomonas vaginalis and candida infection were also obtained. HIV-1-RNA in plasma, proviral HIV-1-DNA, cell associated and cell-free HIV-1 RNA in cervico-vaginal secretions were quantitatively evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). Main outcome measure: Prevalences of HIV related nucleic acids in cervico-vaginal secretions and their univariate and multivariate associations with clinical variables. Results: Proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA were detected in 50% (61/122), 37.7% (46/122) and 32.8% (40/122) of the patients, respectively. In logistic regression analysis, the presence of HIV-1 RNA in blood was the factor which correlated best with the detection of HIV-1 DNA (OR = 5.48, 95% CI = 2.28-13.20), cell-associated (OR = 4.85; 95% CI = 1.89-12.45) and cell-free HIV-1 RNA (OR = 4.63, 95% CI = 1.74-12.33) in cervico-vaginal samples. However, between 20% and to 35% of patients who tested negative for blood HIV-1 RNA were positive for either HIV-1 DNA or HIV-1 RNA detection in cervico-vaginal lavages. Bacterial vaginosis was associated with an increased prevalence of cell-associated (OR = 3.58, 95% CI = 1.22-10.54) and cell-free HIV-1 RNA (OR = 2.94, 95% CI = 1.0-8.7) detection in cervico-vaginal secretions. Additional factors associated with increased prevalence of HIV-1 RNA detection were advanced stage of HIV disease and vulvovaginal candidiasis. Conclusions: Although the presence of HIV-1 RNA in blood is the factor which correlates best with the detection of HIV-related nucleic acids in cervico-vaginal secretions, the shedding of HIV in the genital tract can occur in 20-30% of non-viremic subjects. Bacterial vaginosis and candida infection could have a facilitating role in local HIV viral replication and shedding.

Original languageEnglish
Pages (from-to)634-641
Number of pages8
JournalBritish Journal of Obstetrics and Gynaecology
Volume108
Issue number6
DOIs
Publication statusPublished - Jun 2001

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Nucleic Acids
HIV-1
RNA
HIV
Bacterial Vaginosis
Vaginal Douching
DNA
Candida
Vulvovaginal Candidiasis
Virus Shedding
Trichomonas vaginalis
Hospital Obstetrics and Gynecology Department
Infection
Reverse Transcriptase Polymerase Chain Reaction
Gynecology
Italy
Observational Studies
Cell Biology
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Factors associated with nucleic acids related to human immunodeficiency virus type 1 in cervico-vaginal secretions. / Spinillo, Arsenio; Debiaggi, Maurizia; Zara, Francesca; Maserati, Renato; Polatti, Franco; De Santolo, Antonella.

In: British Journal of Obstetrics and Gynaecology, Vol. 108, No. 6, 06.2001, p. 634-641.

Research output: Contribution to journalArticle

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title = "Factors associated with nucleic acids related to human immunodeficiency virus type 1 in cervico-vaginal secretions",
abstract = "Objective: To assess HIV-related nucleic acids in cervico-vaginal secretions and the factors associated with them. Design: Observational study. Setting: Department of Obstetrics and Gynaecology, University of Pavia, Italy. Population: HIV-positive patients attending a cytology service. Methods: Paired blood and cervico-vaginal lavage samples were obtained from 122 known HIV-seropositive patients during periodic visits for cytologic screening for lower genital tract neoplasia. Vaginal specimens for the diagnosis of bacterial vaginosis, trichomonas vaginalis and candida infection were also obtained. HIV-1-RNA in plasma, proviral HIV-1-DNA, cell associated and cell-free HIV-1 RNA in cervico-vaginal secretions were quantitatively evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). Main outcome measure: Prevalences of HIV related nucleic acids in cervico-vaginal secretions and their univariate and multivariate associations with clinical variables. Results: Proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA were detected in 50{\%} (61/122), 37.7{\%} (46/122) and 32.8{\%} (40/122) of the patients, respectively. In logistic regression analysis, the presence of HIV-1 RNA in blood was the factor which correlated best with the detection of HIV-1 DNA (OR = 5.48, 95{\%} CI = 2.28-13.20), cell-associated (OR = 4.85; 95{\%} CI = 1.89-12.45) and cell-free HIV-1 RNA (OR = 4.63, 95{\%} CI = 1.74-12.33) in cervico-vaginal samples. However, between 20{\%} and to 35{\%} of patients who tested negative for blood HIV-1 RNA were positive for either HIV-1 DNA or HIV-1 RNA detection in cervico-vaginal lavages. Bacterial vaginosis was associated with an increased prevalence of cell-associated (OR = 3.58, 95{\%} CI = 1.22-10.54) and cell-free HIV-1 RNA (OR = 2.94, 95{\%} CI = 1.0-8.7) detection in cervico-vaginal secretions. Additional factors associated with increased prevalence of HIV-1 RNA detection were advanced stage of HIV disease and vulvovaginal candidiasis. Conclusions: Although the presence of HIV-1 RNA in blood is the factor which correlates best with the detection of HIV-related nucleic acids in cervico-vaginal secretions, the shedding of HIV in the genital tract can occur in 20-30{\%} of non-viremic subjects. Bacterial vaginosis and candida infection could have a facilitating role in local HIV viral replication and shedding.",
author = "Arsenio Spinillo and Maurizia Debiaggi and Francesca Zara and Renato Maserati and Franco Polatti and {De Santolo}, Antonella",
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AU - Debiaggi, Maurizia

AU - Zara, Francesca

AU - Maserati, Renato

AU - Polatti, Franco

AU - De Santolo, Antonella

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N2 - Objective: To assess HIV-related nucleic acids in cervico-vaginal secretions and the factors associated with them. Design: Observational study. Setting: Department of Obstetrics and Gynaecology, University of Pavia, Italy. Population: HIV-positive patients attending a cytology service. Methods: Paired blood and cervico-vaginal lavage samples were obtained from 122 known HIV-seropositive patients during periodic visits for cytologic screening for lower genital tract neoplasia. Vaginal specimens for the diagnosis of bacterial vaginosis, trichomonas vaginalis and candida infection were also obtained. HIV-1-RNA in plasma, proviral HIV-1-DNA, cell associated and cell-free HIV-1 RNA in cervico-vaginal secretions were quantitatively evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). Main outcome measure: Prevalences of HIV related nucleic acids in cervico-vaginal secretions and their univariate and multivariate associations with clinical variables. Results: Proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA were detected in 50% (61/122), 37.7% (46/122) and 32.8% (40/122) of the patients, respectively. In logistic regression analysis, the presence of HIV-1 RNA in blood was the factor which correlated best with the detection of HIV-1 DNA (OR = 5.48, 95% CI = 2.28-13.20), cell-associated (OR = 4.85; 95% CI = 1.89-12.45) and cell-free HIV-1 RNA (OR = 4.63, 95% CI = 1.74-12.33) in cervico-vaginal samples. However, between 20% and to 35% of patients who tested negative for blood HIV-1 RNA were positive for either HIV-1 DNA or HIV-1 RNA detection in cervico-vaginal lavages. Bacterial vaginosis was associated with an increased prevalence of cell-associated (OR = 3.58, 95% CI = 1.22-10.54) and cell-free HIV-1 RNA (OR = 2.94, 95% CI = 1.0-8.7) detection in cervico-vaginal secretions. Additional factors associated with increased prevalence of HIV-1 RNA detection were advanced stage of HIV disease and vulvovaginal candidiasis. Conclusions: Although the presence of HIV-1 RNA in blood is the factor which correlates best with the detection of HIV-related nucleic acids in cervico-vaginal secretions, the shedding of HIV in the genital tract can occur in 20-30% of non-viremic subjects. Bacterial vaginosis and candida infection could have a facilitating role in local HIV viral replication and shedding.

AB - Objective: To assess HIV-related nucleic acids in cervico-vaginal secretions and the factors associated with them. Design: Observational study. Setting: Department of Obstetrics and Gynaecology, University of Pavia, Italy. Population: HIV-positive patients attending a cytology service. Methods: Paired blood and cervico-vaginal lavage samples were obtained from 122 known HIV-seropositive patients during periodic visits for cytologic screening for lower genital tract neoplasia. Vaginal specimens for the diagnosis of bacterial vaginosis, trichomonas vaginalis and candida infection were also obtained. HIV-1-RNA in plasma, proviral HIV-1-DNA, cell associated and cell-free HIV-1 RNA in cervico-vaginal secretions were quantitatively evaluated by competitive polymerase chain reaction (c-PCR) and reverse transcriptase PCR (cRT-PCR). Main outcome measure: Prevalences of HIV related nucleic acids in cervico-vaginal secretions and their univariate and multivariate associations with clinical variables. Results: Proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA were detected in 50% (61/122), 37.7% (46/122) and 32.8% (40/122) of the patients, respectively. In logistic regression analysis, the presence of HIV-1 RNA in blood was the factor which correlated best with the detection of HIV-1 DNA (OR = 5.48, 95% CI = 2.28-13.20), cell-associated (OR = 4.85; 95% CI = 1.89-12.45) and cell-free HIV-1 RNA (OR = 4.63, 95% CI = 1.74-12.33) in cervico-vaginal samples. However, between 20% and to 35% of patients who tested negative for blood HIV-1 RNA were positive for either HIV-1 DNA or HIV-1 RNA detection in cervico-vaginal lavages. Bacterial vaginosis was associated with an increased prevalence of cell-associated (OR = 3.58, 95% CI = 1.22-10.54) and cell-free HIV-1 RNA (OR = 2.94, 95% CI = 1.0-8.7) detection in cervico-vaginal secretions. Additional factors associated with increased prevalence of HIV-1 RNA detection were advanced stage of HIV disease and vulvovaginal candidiasis. Conclusions: Although the presence of HIV-1 RNA in blood is the factor which correlates best with the detection of HIV-related nucleic acids in cervico-vaginal secretions, the shedding of HIV in the genital tract can occur in 20-30% of non-viremic subjects. Bacterial vaginosis and candida infection could have a facilitating role in local HIV viral replication and shedding.

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