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Antiretroviral Adherence and Development of Drug Resistance Are the Strongest Predictors of Genital HIV-1 Shedding among Women Initiating Treatment

  作者 Graham, SM; Masese, L; Gitau, R; Jalalian-Lechak, Z; Richardson, BA; Peshu, N; Mandaliya, K; Kiarie, JN; Jaoko, W; Ndinya-Achola, J; Overbaugh, J; McClelland, RS  
  选自 期刊  Journal of Infectious Diseases;  卷期  2010年202-10;  页码  1538-1542  
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[摘要]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 (Pp. 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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