Comparison of sampling methods to measure HIV RNA viral load in female genital tract secretions
Shameem Z Jaumdally1, Heidi E Jones2, Donald R Hoover3
1Division of Medical Virology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.
Problem:
How does menstrual cup (MC) compare to other genital sampling methods for HIV RNA recovery?
Method Of Study:
We compared HIV RNA levels between MC, endocervical swab (ECS), and ECS-enriched cervicovaginal lavage (eCVL) specimens in 51 HIV-positive, antiretroviral therapy-naive women at enrollment, 3 and 6 months, with order rotated by visit. Paired comparisons were analyzed with McNemar's exact tests, signed-rank tests, and an extension of Somer's D for pooled analyses across visits.
Results:
MC specimens had the highest proportion of quantifiable HIV VL at enrollment and month 3, but more MC specimens (n=12.8%) were insufficient for testing, compared with ECS (2%, P=0.006) and eCVL (0%, P<0.001). Among sufficient specimens, median VL was significantly higher for MC (2.62 log10 copies/mL) compared to ECS (1.30 log10 copies/mL, P<0.001) and eCVL (1.60 log10 copies/mL, P<0.001) across visits.
Conclusion:
MC may be more sensitive than eCVL and CVS, provided insufficient specimens are reduced.
