Sub-optimal adherence to antiretroviral therapy is the single most important factor associated with genital shedding of HIV in women, investigators report in the online edition of the Journal of Infectious Diseases.
‘This is the largest prospective study of female genital HIV-1 shedding after ART [antiretroviral therapy] initiation that has been conducted to date”, comment the investigators, “adherence was the most important determinant of genital shedding during the women’s first 6 months of NNRTI-based ART and remained a significant predictor after adjustment for plasma viral load.”
Antiretroviral therapy lowers viral load in the blood and other bodily fluids, including genital secretions. Lower genital levels of HIV have been associated with a reduced risk of sexual transmission of the virus and there is currently significant interest in the use of antiretroviral treatment as a method of HIV prevention.
However, it is known that women taking HIV treatment may occasionally shed HIV in their genital fluids.
An international team of investigators wanted to see which factors were associated with this.In particular they wanted to find out whether factors associated with viral shedding in women not receiving treatment - such as infections - remained the most important predictors of viral shedding in women receiving antiretroviral treatment.
They therefore designed a study involving 102 Kenyan women starting antiretroviral therapy. Every three months, viral load was monitored in blood, cervical fluids, and vaginal secretions.
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