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

Sara Gianella; Andrew D. Redd; Mary K. Grabowski; Aaron A.R. Tobian; David Serwadda; Kevin Newell; Eshan U. Patel; Sarah Kalibbala; Paschal Ssebbowa; Ronald H. Gray; Thomas C. Quinn; Steven J. Reynolds

doi:10.1093/infdis/jiv135

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

Sara Gianella, Andrew D. Redd, Mary K. Grabowski, Aaron A.R. Tobian, David Serwadda, Kevin Newell, Eshan U. Patel, Sarah Kalibbala, Paschal Ssebbowa, Ronald H. Gray, Thomas C. Quinn, Steven J. Reynolds

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13 Scopus citations

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.

Original language	English (US)
Pages (from-to)	899-903
Number of pages	5
Journal	Journal of Infectious Diseases
Volume	212
Issue number	6
DOIs	https://doi.org/10.1093/infdis/jiv135
State	Published - Sep 15 2015

Keywords

Uganda
acyclovir
antiretroviral therapy (ART)
cytomegalovirus (CMV)
human immunodeficiency virus (HIV)
immune reconstitution inflammatory syndrome (IRIS)
reactivation

ASJC Scopus subject areas

Immunology and Allergy
Infectious Diseases

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10.1093/infdis/jiv135

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Gianella, S., Redd, A. D., Grabowski, M. K., Tobian, A. A. R., Serwadda, D., Newell, K., Patel, E. U., Kalibbala, S., Ssebbowa, P., Gray, R. H., Quinn, T. C., & Reynolds, S. J. (2015). Vaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, Uganda. Journal of Infectious Diseases, 212(6), 899-903. https://doi.org/10.1093/infdis/jiv135

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title = "Vaginal Cytomegalovirus Shedding Before and After Initiation of Antiretroviral Therapy in Rakai, 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.",

keywords = "Uganda, acyclovir, antiretroviral therapy (ART), cytomegalovirus (CMV), human immunodeficiency virus (HIV), immune reconstitution inflammatory syndrome (IRIS), reactivation",

author = "Sara Gianella and Redd, {Andrew D.} and Grabowski, {Mary K.} and Tobian, {Aaron A.R.} and David Serwadda and Kevin Newell and Patel, {Eshan U.} and Sarah Kalibbala and Paschal Ssebbowa and Gray, {Ronald H.} and Quinn, {Thomas C.} and Reynolds, {Steven J.}",

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doi = "10.1093/infdis/jiv135",

language = "English (US)",

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AU - Gianella, Sara

AU - Redd, Andrew D.

AU - Grabowski, Mary K.

AU - Tobian, Aaron A.R.

AU - Serwadda, David

AU - Newell, Kevin

AU - Patel, Eshan U.

AU - Kalibbala, Sarah

AU - Ssebbowa, Paschal

AU - Gray, Ronald H.

AU - Quinn, Thomas C.

AU - Reynolds, Steven J.

PY - 2015/9/15

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AB - 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.

KW - Uganda

KW - acyclovir

KW - antiretroviral therapy (ART)

KW - cytomegalovirus (CMV)

KW - human immunodeficiency virus (HIV)

KW - immune reconstitution inflammatory syndrome (IRIS)

KW - reactivation

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JF - Journal of Infectious Diseases

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

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