Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding. (March 2017)

• Record Type: Journal Article
• Authors: McNicholl, Janet M; Leelawiwat, Wanna; Whitehead, Sara; Hanson, Debra L; Evans-Strickfaden, Tammy; Cheng, Chen Y; Chonwattana, Wannee; Mueanpai, Famui; Kittinunvorakoon, Chonticha; Markowitz, Lauri; Dunne, Eileen F
• Is Part Of: International journal of STD & AIDS. Volume 28:Number 4(2017:Apr.)
• Page Start: 372
• Page End: 379
• Publication Date: 2017-03
• Subjects: Virus -- polymerase chain reaction -- sampling -- sexually transmitted infection -- ano-genital -- transmission -- self-collection; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462416650123
• Languages: English
• ISSNs: 0956-4624

Abstract

HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher's exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman's rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling.