Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV-1 Shedding among Women Initiating Treatment

被引：43
作者：
Graham, Susan M. [1 ,3 ,5 ,7 ]
Masese, Linnet [1 ,3 ]
Gitau, Ruth [3 ]
Jalalian-Lechak, Zahra [2 ]
Richardson, Barbra A. [1 ]
Peshu, Norbert [5 ]
Mandaliya, Kishor [6 ]
Kiarie, James N. [4 ]
Jaoko, Walter [3 ]
Ndinya-Achola, Jeckoniah [3 ]
Overbaugh, Julie [2 ]
McClelland, R. Scott [1 ,3 ]
机构：
[1] Univ Washington, Seattle, WA 98104 USA
[2] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[3] Univ Nairobi, Nairobi, Kenya
[4] Kenyatta Natl Hosp, Nairobi, Kenya
[5] Kenya Govt Med Res Ctr, Kilifi, Kenya
[6] Coast Prov Gen Hosp, Mombasa, Kenya
[7] Univ Toronto, Toronto, ON, Canada
来源：
JOURNAL OF INFECTIOUS DISEASES | 2010年 / 202卷 / 10期
基金：
美国国家卫生研究院;
关键词：
VIRAL LOAD; THERAPY; TRANSMISSION; TRACT; RNA; PREVENTION; RISK;
D O I：
10.1086/656790
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Persistent genital human immunodeficiency virus type 1 (HIV-1) shedding among women receiving antiretroviral therapy (ART) may present a transmission risk. We investigated the associations between genital HIV-1 suppression after ART initiation and adherence, resistance, pretreatment CD4 cell count, and hormonal contraceptive use. First-line ART was initiated in 102 women. Plasma and genital HIV-1 RNA levels were measured at months 0, 3, and 6. Adherence was a strong and consistent predictor of genital HIV-1 suppression (P < .001), whereas genotypic resistance was associated with higher vaginal HIV-1 RNA level at month 6 (Pp. 04). These results emphasize the importance of adherence to optimize the potential benefits of ART for reducing HIV-1 transmission risk.
引用
收藏
页码：1538 / 1542
页数：5
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