Association between paired plasma and cervicovaginal lavage fluid HIV-1 RNA levels during 36 months

J Acquir Immune Defic Syndr. 2006 Aug 15;42(5):584-7. doi: 10.1097/01.qai.0000229997.52246.95.


Objective: To determine the patterns and predictors of genital tract HIV-1 RNA levels during a 36-month period.

Methods: HIV-1 RNA levels were measured blood in plasma and the genital tract (by cervicovaginal lavage [CVL]) at baseline before highly, active antiretroviral therapy, at 2 and 4 weeks and every 6 months. Viral loads were measured using nucleic acid sequence-based amplification assay with a lower limit of detection of 2.6 log10 copies/mL.

Results: Ninety-seven women had a median of 30.4 months' follow-up, with 530 paired PVL and CVL specimens. The strongest predictor of CVL fluid HIV-1 RNA detection was PVL of more than 2.6 log10 copies/mL, with an odds ratio of 13.7 (P < 0.0001). Each log10 unit increase in PVL increased the odds of detecting HIV-1 RNA in CVL fluid by 2.6 folds (P = 0.0002). Cervicovaginal lavage fluid HIV-1 RNA exceeded PVL on 5% of visits. When patients achieved undetectable levels of HIV-1 RNA in both plasma and CVL fluid, rebound of HIV-1 RNA occurred in plasma first or concurrently with CVL fluid HIV-1 RNA.

Conclusions: Plasma viral load is the strongest predictor of CVL fluid HIV-1 RNA detection. Cervicovaginal lavage fluid HIV-1 RNA levels are generally lower than PVL. Plasma viral load is more likely to rebound first or at the same time as CVL fluid viral load.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Antiretroviral Therapy, Highly Active
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification*
  • Humans
  • RNA, Viral / analysis*
  • RNA, Viral / blood
  • Statistics as Topic
  • Vagina / virology*
  • Vaginal Douching
  • Viral Load
  • Viremia


  • RNA, Viral