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Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e3182712286
Basic Science

Is There an Association Between HIV-1 Genital Shedding and Cervical Intraepithelial Neoplasia 2/3 Among Women on Antiretroviral Therapy?

Huchko, Megan Justine MD, MPH1; Woo, Victoria MD1; Liegler, Teri PhD2; Leddy, Anna BA1; Smith-McCune, Karen MD, PhD1; Sawaya, George F. MD1,3; Bukusi, Elizabeth A. M.Med, MD, MPH, PhD1,4,5; Cohen, Craig R. MD, MPH1

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Objective: Given the high prevalence of cervical intraepithelial neoplasia (CIN) grade 2/3 among HIV-infected women, we sought to examine the relationship between CIN 2/3 and HIV-1 genital shedding among women on highly active antiretroviral therapy (HAART).

Materials and Methods: Paired plasma and cervical wick specimens for HIV-1 RNA measurements were obtained from 44 HIV-infected women with biopsy-confirmed CIN 2/3 (cases) and 44 age-matched HIV-infected women with normal cervical findings on colposcopy (controls). All subjects tested negative for sexually transmitted infections and had been stable on HAART for at least 3 months. HIV-1 viral load was measured in both blood and cervical specimens using commercial real-time polymerase chain reaction assays.

Results: Cervical intraepithelial neoplasia 2/3 was not significantly associated with the detection or magnitude of plasma or cervical HIV-1 RNA shedding. HIV was detected in the plasma in 10 cases (23%) and 10 controls (25%) (odds ratio = 1.0; 95% confidence interval = 0.33–3.1). Cervical HIV-1 was detected in 6 cases (13.6%) and 9 controls (20.4%) (odds ratio = 0.61; 95% confidence interval = 0.20–1.90). Mean HIV-1 concentration in cervical secretions among women with CIN 2/3 who shed was 2.93 log10 copies versus 2.72 among controls (p = .65).

Conclusions: Among women on HAART, we found no relationship between CIN 2/3 and HIV-1 genital shedding.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology


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