Vaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, Uganda
Title | Vaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, Uganda |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Gianella, S, Redd, AD, Grabowski, MK, Tobian, AA, Serwadda, D, Newell, K, Patel, EU, Kalibbala, S, Ssebbowa, P, Gray, RH, Quinn, TC, Reynolds, SJ |
Journal | J Infect Dis |
Volume | 212 |
Pagination | 899-903 |
Date Published | Mar 5 |
ISBN Number | 1537-6613 (Electronic)0022-1899 (Linking) |
Accession Number | 25743428 |
Keywords | acyclovir, antiretroviral therapy (ART), cytomegalovirus (CMV), human immunodeficiency virus (HIV), immune reconstitution inflammatory syndrome (IRIS), reactivation, Uganda |
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. |
PMCID | PMC4548459 |