Treatment of cervicitis is associated with decreased cervical shedding of HIV-1

AIDS. 2001 Jan 5;15(1):105-10. doi: 10.1097/00002030-200101050-00015.


Objective: To determine whether cervical mucosal shedding of HIV-1 RNA and HIV-1 infected cells decreases following successful treatment of cervicitis.

Design: Prospective interventional study.

Setting: Sexually Transmitted Infections Clinic, Coast Provincial General Hospital, Mombasa, Kenya.

Participants: Thirty-six HIV-1 seropositive women with cervicitis: 16 with Neisseria gonorrhoeae, seven with Chlamydia trachomatis, and 13 with non-specific cervicitis.

Interventions: Treatment of cervicitis.

Main outcome measures: Levels of total (cell-free and cell-associated) HIV-1 RNA and presence of HIV-1 DNA (a marker for infected cells) in cervical secretions before and after resolution of cervicitis.

Results: After treatment of cervicitis, the median HIV-1 RNA concentration in cervical secretions was reduced from 4.05 to 3.24 log10 copies/swab (P = 0.001). Significant decreases in cervical HIV-1 RNA occurred in the subgroups with N. gonorrhoeae (3.94 to 3.28 log10 copies/swab; P = 0.02) and C. trachomatis (4.21 to 3.19 log10 copies/swab; P = 0.02). Overall, the prevalence of HIV-1 infected cells in cervical secretions also decreased after treatment, from 67% to 42% (odds ratio, 2.8; 95% confidence interval, 1.3-6.0; P = 0.009). Detection of infected cells was associated with higher mean HIV-1 RNA levels (4.04 versus 2.99 log10 copies/swab; P< 0.0001).

Conclusions: Effective treatment of cervicitis resulted in significant decreases in shedding of HIV-1 virus and infected cells in cervical secretions. Treatment of sexually transmitted diseases may be an important means of decreasing the infectivity of HIV-1 seropositive women by reducing exposure to HIV-1 in genital secretions.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / virology
  • Adult
  • Anti-Bacterial Agents
  • Anti-Infective Agents / therapeutic use
  • Cervix Uteri / immunology
  • Cervix Uteri / virology*
  • Chlamydia Infections / drug therapy*
  • Chlamydia Infections / virology
  • Chlamydia trachomatis*
  • Female
  • Gonorrhea / drug therapy*
  • Gonorrhea / epidemiology
  • Gonorrhea / virology
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Humans
  • Kenya / epidemiology
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • RNA, Viral / metabolism
  • Uterine Cervicitis / drug therapy*
  • Uterine Cervicitis / epidemiology
  • Uterine Cervicitis / virology
  • Virus Shedding / drug effects*
  • Women's Health


  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • RNA, Viral