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Protease inhibitor effects on prevalence of bacterial vaginosis and human papillomavirus‐related lesions
Author(s) -
Marques Marcos P. C.,
Pinto Amanda C.,
Soares Leila C.,
Macedo Jacyara M. B.,
dos Santos Débora F.,
Oliveira Marco A. P.
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14245
Subject(s) - bacterial vaginosis , medicine , odds ratio , viral load , polymerase chain reaction , amprenavir , hpv infection , immunology , obstetrics , virus , protease , cervical cancer , biology , cancer , biochemistry , gene , hiv 1 protease , enzyme
Aim Antiretrovirals of the protease inhibitor (PI) class tend to achieve low concentrations in biological fluids. This study aimed to analyze possible changes in the vaginal microbiome and frequency of cervical human papillomavirus (HPV)‐DNA and HPV‐related lesions associated with the use of PI in antiretroviral therapy (ART). Methods Eighty‐eight women with human immunodeficiency virus infection were divided in two groups: ART with PI and without PI. All the participants underwent anamnesis with demographic data collection. The total DNA, used as the template in the polymerase chain reaction‐based assays for the detection of HPV‐DNA, was extracted from cervical samples during cervical cytopathology. Results There were no differences between the groups with respect to HPV‐related lesions. Despite the higher prevalence of bacterial vaginosis (BV) in the PI group (33.96% vs 17.14%), the difference was insignificant when considering all women ( P = 0.066). When women with a detectable viral load and a CD4+ T‐cell count <200 were excluded in both groups, BV was found to be more prevalent in the PI group (odds ratio, 3.349; 95% confidence interval, 1.113–11.41, P = 0.049). No associations were found between BV and age, condom use, cervical HPV, time with current ART regimen, unprotected receptive anal intercourse and cervical HPV‐related lesions. Conclusion The use of PI did not alter the frequencies of HPV‐DNA and HPV‐related lesions. However, an increased frequency of BV was found in women using PI after excluding women with a detectable viral load and a CD4+ T‐cell count of <200.