دورية أكاديمية
أعرض في EDS

Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women.

التفاصيل البيبلوغرافية
العنوان: Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women.
المؤلفون: McKinnon LR; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.; Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa., Liebenberg LJ; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa., Yende-Zuma N; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa., Archary D; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa., Ngcapu S; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa., Sivro A; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.; Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa., Nagelkerke N; Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada., Garcia Lerma JG; Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Kashuba AD; Eschelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Masson L; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa., Mansoor LE; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa., Karim QA; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Epidemiology, Columbia University, New York, New York, USA., Karim SSA; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Department of Epidemiology, Columbia University, New York, New York, USA., Passmore JS; Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.; Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.; National Health Laboratory Service, Cape Town, South Africa.
المصدر: Nature medicine [Nat Med] 2018 May; Vol. 24 (4), pp. 491-496. Date of Electronic Publication: 2018 Feb 26.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Company Country of Publication: United States NLM ID: 9502015 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1546-170X (Electronic) Linking ISSN: 10788956 NLM ISO Abbreviation: Nat Med Subsets: MEDLINE
أسماء مطبوعة: Publication: New York Ny : Nature Publishing Company
Original Publication: New York, NY : Nature Pub. Co., [1995-
مواضيع طبية MeSH: Genitalia, Female/*pathology , HIV Infections/*drug therapy , HIV Infections/*virology , Inflammation/*drug therapy , Tenofovir/*therapeutic use, Cytokines/metabolism ; Female ; Genitalia, Female/drug effects ; Genitalia, Female/virology ; HIV Infections/pathology ; Humans ; Inflammation/pathology ; Multivariate Analysis ; Tenofovir/pharmacology ; Treatment Outcome
مستخلص: Several clinical trials have demonstrated that antiretroviral (ARV) drugs taken as pre-exposure prophylaxis (PrEP) can prevent HIV infection, with the magnitude of protection ranging from -49 to 86% (refs. ). Although these divergent outcomes are thought to be due primarily to differences in product adherence, biological factors likely contribute. Despite selective recruitment of higher-risk participants for prevention trials, HIV risk is heterogeneous even within higher-risk groups. To determine whether this heterogeneity could influence patient outcomes following PrEP, we undertook a post hoc prospective analysis of results from the CAPRISA 004 trial for 1% tenofovir gel (n = 774 patients), one of the first trials to demonstrate protection against HIV infection. Concentrations of nine proinflammatory cytokines were measured in cervicovaginal lavages at >2,000 visits, and a graduated cytokine score was used to define genital inflammation. In women without genital inflammation, tenofovir was 57% protective against HIV (95% confidence interval (CI): 7-80%) but was 3% protective (95% CI: -104-54%) if genital inflammation was present. Among women who highly adhered to the gel, tenofovir protection was 75% (95% CI: 25-92%) in women without inflammation compared to -10% (95% CI: -184-57%) in women with inflammation. Immunological predictors of HIV risk may modify the effectiveness of tools for HIV prevention; reducing genital inflammation in women may augment HIV prevention efforts.
التعليقات: Comment in: Nat Med. 2018 Apr 10;24(4):384-385. (PMID: 29634687)
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معلومات مُعتمدة: P30 AI050410 United States AI NIAID NIH HHS; R01 AI111936 United States AI NIAID NIH HHS
المشرفين على المادة: 0 (Cytokines)
99YXE507IL (Tenofovir)
تواريخ الأحداث: Date Created: 20180227 Date Completed: 20190520 Latest Revision: 20200328
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC5893390
DOI: 10.1038/nm.4506
PMID: 29480895
قاعدة البيانات: MEDLINE
الوصف
تدمد:1546-170X
DOI:10.1038/nm.4506