Vaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, Uganda.

TitleVaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, Uganda.
Publication TypeJournal Article
Year of Publication2015
AuthorsGianella, S, Redd, AD, Grabowski, MK, Tobian, AAR, Serwadda, D, Newell, K, Patel, EU, Kalibbala, S, Ssebbowa, P, Gray, RH, Quinn, TC, Reynolds, SJ
JournalJ Infect Dis
Volume212
Issue6
Pagination899-903
Date Published2015 Sep 15
ISSN1537-6613
KeywordsAcyclovir, Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Coinfection, Cytomegalovirus, Cytomegalovirus Infections, Double-Blind Method, Female, Herpes Genitalis, Herpesvirus 2, Human, HIV Infections, Humans, Longitudinal Studies, Uganda, Vagina, Virus Shedding
Abstract

Vaginal shedding of cytomegalovirus (CMV) DNA was determined longitudinally among 96 women coinfected with human immunodeficiency virus (HIV), herpes simplex virus 2, and CMV starting antiretroviral therapy (ART) during a placebo-controlled trial of HSV-2 suppression with acyclovir in Rakai, Uganda. Vaginal CMV was detected in 75 of 96 women (78.0%) and 379 of 1080 individual visits (35.1%). ART status, higher HIV RNA viral load before ART initiation, and younger age were significantly associated with increased frequency of CMV shedding (P < .01). Compared to pre-ART, CMV shedding peaked from month 2 to month 4 after ART initiation, suggesting possible immune reconstitution inflammatory syndrome. Further studies need to determine the clinical significance of asymptomatic CMV shedding.

DOI10.1093/infdis/jiv135
Alternate JournalJ. Infect. Dis.
PubMed ID25743428
PubMed Central IDPMC4548459
Grant List1K23AI093152-01A1 / AI / NIAID NIH HHS / United States
7-UM1 AI068636-07 / AI / NIAID NIH HHS / United States
AI-30731-19 / AI / NIAID NIH HHS / United States
AI100665 / AI / NIAID NIH HHS / United States
HHSN261200800001E / / PHS HHS / United States
P30 AI036214 / AI / NIAID NIH HHS / United States
P30-AI027763 / AI / NIAID NIH HHS / United States
R24AI106039 / AI / NIAID NIH HHS / United States
T32AI102623 / AI / NIAID NIH HHS / United States
UL1TR000100 / TR / NCATS NIH HHS / United States