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. 2010 Nov 15;202(10):1538-42.
doi: 10.1086/656790. Epub 2010 Oct 5.

Antiretroviral adherence and development of drug resistance are the strongest predictors of genital HIV-1 shedding among women initiating treatment

Susan M Graham  1 , Linnet Masese, Ruth Gitau, Zahra Jalalian-Lechak, Barbra A Richardson, Norbert Peshu, Kishor Mandaliya, James N Kiarie, Walter Jaoko, Jeckoniah Ndinya-Achola, Julie Overbaugh, R Scott McClelland
Affiliations

Antiretroviral adherence and development of drug resistance are the strongest predictors of genital HIV-1 shedding among women initiating treatment

Susan M Graham et al. J Infect Dis. .

Abstract

Persistent genital human immunodeficiency virus type 1 (HIV-1) shedding among women receiving antiretroviral therapy (ART) may present a transmission risk. We investigated the associations between genital HIV-1 suppression after ART initiation and adherence, resistance, pretreatment CD4 cell count, and hormonal contraceptive use. First-line ART was initiated in 102 women. Plasma and genital HIV-1 RNA levels were measured at months 0, 3, and 6. Adherence was a strong and consistent predictor of genital HIV-1 suppression (P < .001), whereas genotypic resistance was associated with higher vaginal HIV-1 RNA level at month 6 (P = .04). These results emphasize the importance of adherence to optimize the potential benefits of ART for reducing HIV-1 transmission risk.

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Conflict of interest statement

Conflicts of interest: None declared.

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