American journal of reproductive immunology (New York, N.Y. : 1989) · 2025
Injectable Contraceptives Differentially Affect Select CD4+ HIV-1 Target Cells in the Genital Tract but Not Systemically: Implications for HIV-1 Acquisition.
СтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Avenant Chanel, Bick Alexis J, Moliki Johnson M, Dlamini Sigcinile, Tomasicchio Michele, Hofmeyr G Justus, Morrison Charles, Chen Pai-Lien, Hapgood Janet P
Аннотация
PROBLEM: Observational data suggest lower HIV susceptibility in women using the injectable contraceptive norethisterone enanthate (NET-EN) versus intramuscular depo medroxyprogesterone acetate (DMPA-IM). Clinical data investigating the effects of injectables on HIV target cells are inconsistent or limited. No data on HIV target cells are available from head-to-head randomized trials comparing DMPA-IM and NET-EN, nor at peak progestin concentrations.
METHOD OF STUDY: The women's health, injectable contraception, and HIV (WHICH) trial randomized women to DMPA-IM or NET-EN at two South African sites (2018-2019). Cells from blood and cytobrushes from women at one site, taken at baseline and 1 week post the 24-week injection (at peak progestin levels), were analyzed by flow cytometry for select HIV-1 target cells (CD4+ cells expressing HIV-1 co-receptors, an integrin and/or activation markers).
RESULTS: Systemically, DMPA-IM and NET-EN similarly reduced the frequency and number of some CD4+ cells and expression of some CD4+ cell surface markers. In contrast, female genital tract (FGT) results showed significantly different cell numbers between contraceptives for most cell populations; DMPA-IM tended to increase, but NET-EN tended to decrease cell numbers. Excluding for non-study progestin use revealed significant increases in frequency and/or number of several FGT cell populations from baseline to 25 weeks, within the DMPA-IM arm.
CONCLUSIONS: Both contraceptives exert minimal effects on systemic CD4+ cells but have differential effects in the FGT. The changes in frequency and numbers of HIV-1 target cells investigated, particularly after exclusion for non-study progestin use, suggest that DMPA-IM use may increase HIV-1 acquisition in the FGT compared to NET-EN use.
METHOD OF STUDY: The women's health, injectable contraception, and HIV (WHICH) trial randomized women to DMPA-IM or NET-EN at two South African sites (2018-2019). Cells from blood and cytobrushes from women at one site, taken at baseline and 1 week post the 24-week injection (at peak progestin levels), were analyzed by flow cytometry for select HIV-1 target cells (CD4+ cells expressing HIV-1 co-receptors, an integrin and/or activation markers).
RESULTS: Systemically, DMPA-IM and NET-EN similarly reduced the frequency and number of some CD4+ cells and expression of some CD4+ cell surface markers. In contrast, female genital tract (FGT) results showed significantly different cell numbers between contraceptives for most cell populations; DMPA-IM tended to increase, but NET-EN tended to decrease cell numbers. Excluding for non-study progestin use revealed significant increases in frequency and/or number of several FGT cell populations from baseline to 25 weeks, within the DMPA-IM arm.
CONCLUSIONS: Both contraceptives exert minimal effects on systemic CD4+ cells but have differential effects in the FGT. The changes in frequency and numbers of HIV-1 target cells investigated, particularly after exclusion for non-study progestin use, suggest that DMPA-IM use may increase HIV-1 acquisition in the FGT compared to NET-EN use.