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Comparison of sampling methods to measure HIV RNA viral load in female genital tract secretions
Author(s) -
Jaumdally Shameem Z.,
Jones Heidi E.,
Hoover Donald R.,
Gamieldien Hoyam,
Kriek JeanMari,
Langwenya tokozo,
Myer Landon,
Passmore JoAnn S.,
Todd Catherine S.
Publication year - 2017
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12619
Subject(s) - mcnemar's test , viral load , genital tract , human immunodeficiency virus (hiv) , medicine , sex organ , rna , gynecology , immunology , gastroenterology , biology , physiology , statistics , mathematics , genetics , biochemistry , gene
Problem How does menstrual cup ( MC ) compare to other genital sampling methods for HIV RNA recovery? Method of study We compared HIV RNA levels between MC , endocervical swab ( ECS ), and ECS ‐enriched cervicovaginal lavage ( eCVL ) specimens in 51 HIV ‐positive, antiretroviral therapy‐naive women at enrollment, 3 and 6 months, with order rotated by visit. Paired comparisons were analyzed with McNemar's exact tests, signed‐rank tests, and an extension of Somer's D for pooled analyses across visits. Results MC specimens had the highest proportion of quantifiable HIV VL at enrollment and month 3, but more MC specimens (n=12.8%) were insufficient for testing, compared with ECS (2%, P =0.006) and eCVL (0%, P <0.001). Among sufficient specimens, median VL was significantly higher for MC (2.62 log 10 copies/ mL ) compared to ECS (1.30 log 10 copies/ mL , P <0.001) and eCVL (1.60 log 10 copies/ mL , P <0.001) across visits. Conclusion MC may be more sensitive than eCVL and CVS , provided insufficient specimens are reduced.