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Cervical HIV Shedding and STIs

Does systemic immune activation increase shedding?

A higher percentage of resting cells, as a result of maximal viral suppression with treatment, may decrease local genital activation, HIV shedding, and transmission, according to a study of 226 HIV-positive women and 569 genital evaluations of which 159 exhibited HIV RNA shedding. Researchers found:

• Systemic T cell activation was associated with genital tract shedding in univariate analysis.

• Systemic T cell activation was not associated with genital tract shedding when adjusting for plasma HIV RNA, sexually transmitted infections (STIs), and genital tract infections.

• Women with high percentage of resting T cells are less likely to have HIV shedding compared to those with lower percentages.

Citation: Spencer LY, Christiansen S, Wang CH, et al. Systemic immune activation and HIV shedding in the female genital tract. JAIDS. [Published online ahead of print August 22, 2015]. doi: 10.1097/QAI.0000000000000823.