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J Virus Erad. 2017 Oct 1;3(4):204-207.

Low-level genital HIV shedding in Thai HIV-infected women with suppressed plasma viral load after menopause: a longitudinal study.

Author information

1
HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand.
2
Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
3
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Abstract

OBJECTIVES:

First, to evaluate the longitudinal changes of HIV RNA in genital secretions in HIV-positive women with plasma HIV RNA <50 copies/mL before and after the onset of menopause. Second, to assess inflammatory markers and prevalence of comorbidities after the onset of menopause.

METHODS:

This was a prospective observational study with two time points. HIV RNA in genital secretions (GVL) was measured in 15 HIV-positive menopausal women (second time point). Results were compared to earlier available data for GVL from the same participant before the onset of menopause (first time point).

RESULTS:

Median age at the first time point was 42 years, and 52 years at the second time point. Median time since the onset of menopause was 2 years and 33% of women were sexually active. Eighty per cent had at least one comorbidity. The GVL before menopause was >50 copies/mL in 27% of the participants, and in 40% after menopause. The GVL was <1000 copies/mL in all but one measurement. There was no significant difference between the two time points (P=0.687). Intermediate vaginal flora or bacterial vaginosis was found in 73% of participants during the second time point.

CONCLUSIONS:

There was a high prevalence of low-level GVL shedding before and after menopause. This needs further investigation, especially in relation to the vaginal microbiome and the complex interactions between micro-organisms. HIV-infected women in menopause do not seem to present a major public health risk for HIV transmission. Nevertheless, safe sex should be discussed with all, regardless of age. The high prevalence of non-communicable diseases after menopause requires special attention and comprehensive care.

KEYWORDS:

HIV and women, menopause, genital viral shedding, metabolic syndrome

PMID:
29057083
PMCID:
PMC5632546

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