RESUMEN

OBJECTIVES: To assess the impact of long-term combined antiretroviral therapy (cART) on HIV-RNA and HIV-DNA levels in cervicovaginal secretions of HIV-1-infected women with sustained undetectable plasma RNA viral load (PVL); to explore factors predictive of residual viral shedding; and to evaluate the risk of heterosexual transmission. METHODS: Women with undetectable PVL (<50 copies/mL) for >6 months were included in this cross-sectional study. HIV-RNA and HIV-DNA were measured in blood and cervicovaginal lavage fluid (CVL). Women were systematically tested for genital infections. The risk of transmission to male partners during unprotected intercourse was estimated. RESULTS: Eighty-one women composed the study population: all had HIV-RNA <40 copies/mL in CVL. HIV-DNA was detectable in CVL of 29/78 patients (37%). There was a weak positive correlation between HIV-DNA levels in PBMCs and CVL (r = 0.20; p = 0.08). In multivariate analysis, two factors were associated with HIV-DNA detection in CVL: previous AIDS-defining illnesses (OR = 11; 95%CI = 2-61) and current residual viremia (20

Asunto(s)

Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/transmisión , Infecciones por VIH/virología , VIH-1/genética , Vagina/virología , Viremia/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Adulto , Antirretrovirales/uso terapéutico , Secreciones Corporales/virología , Recuento de Linfocito CD4 , Estudios Transversales , ADN Viral/aislamiento & purificación , Femenino , Humanos , Persona de Mediana Edad , ARN Viral/aislamiento & purificación , Riesgo , Carga Viral , Esparcimiento de Virus