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Effect of the Levonorgestrel Intrauterine Device on Genital HIV-1 RNA Shedding Among HIV-1–Infected Women Not Taking Antiretroviral Therapy in Nairobi, Kenya

Coleman, Jenell S. MD, MPH*; Mwachari, Christina MBChB, MSc, MPH; Balkus, Jennifer PhD, MPH; Sanguli, Lucy; Muliro, Angela MBChB, MMed; Agnew, Kathy BS§; Coombs, Robert W. MD, PhD, FRCPC; Cohen, Craig R MD, MPH; Hitti, Jane MD, MPH§

JAIDS Journal of Acquired Immune Deficiency Syndromes: June 1st, 2013 - Volume 63 - Issue 2 - p 245–248
doi: 10.1097/QAI.0b013e31828decf8
Brief Report: Epidemiology and Prevention

Abstract: The effect of the levonorgestrel-releasing intrauterine device (LNG-IUD) on genital HIV-1 RNA shedding and inflammation among 25 HIV-infected women was evaluated. Blood, endocervical, and cervicovaginal lavage samples were collected from HIV-infected women not taking antiretrovirals before LNG-IUD insertion and 1 month, 3 month, and 6 months thereafter. HIV-1 RNA was quantitated by real-time reverse transcriptase–polymerase chain reaction. Inflammatory markers were measured by enzyme immunoassay. Genital HIV-1 RNA shedding and inflammatory markers did not differ between LNG-IUD placement and month 6, with the exception of interleukin 1β that increased (0.42 log10; 95% confidence interval: 0.10 to 0.75). The LNG-IUD did not increase genital HIV-1 RNA shedding after 6 months of use.

*Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD;

Kenya Medical Research Institute; Nairobi, Kenya;

Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA;

§Departments of Obstetrics and Gynecology; and

Laboratory Medicine and Medicine, University of Washington, Seattle, WA; and

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA.

Correspondence to: Jenell S. Coleman, MD, MPH, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Phipps Building Room 249B, Baltimore, Maryland 21287 (Email:

Supported by a grant from the Puget Sound Partners for Global Health (grant #2007-32); the American College of Obstetrics and Gynecology; UW CFAR, P30 AI-27757; AI-38858; and HD-40540.

The authors have no conflicts of interest to disclose.

The authors J.S.C. and C.M. contributed equally to this work.

This abstract was presented at the 17th Conference on Retroviruses and Opportunistic Infections, February 16–19, 2010, San Francisco, CA.

This research was conducted in Nairobi, Kenya.

Received October 17, 2012

Accepted February 18, 2013

© 2013 by Lippincott Williams & Wilkins