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Updated: May 15, 2025
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Ex Vivo Infection of Human Lymphoid Tissue and Female Genital Mucosa with Human Immunodeficiency Virus 1 and Histoculture
Published on: October 12, 2018
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Injectable Contraceptives Differentially Affect Select CD4+ HIV-1 Target Cells in the Genital Tract but Not
Chanel Avenant1, Alexis J Bick1, Johnson M Moliki1
1Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa.
Summary
Injectable contraceptives norethisterone enanthate (NET-EN) and depo medroxyprogesterone acetate (DMPA-IM) have different effects on HIV target cells in the female genital tract. DMPA-IM may increase HIV risk compared to NET-EN.
Area of Science:
- Reproductive Health
- Infectious Disease Epidemiology
- Immunology
Background:
- Injectable contraceptives are widely used globally.
- Observational studies suggest varied HIV susceptibility with different progestin-only injectables.
- Limited clinical data exist on the impact of DMPA-IM versus NET-EN on HIV target cells.
Purpose of the Study:
- To compare the effects of DMPA-IM and NET-EN on HIV-1 target cells in systemic and female genital tract compartments.
- To investigate these effects at peak progestin concentrations in a head-to-head randomized trial.
Main Methods:
- The WHICH trial randomized women to DMPA-IM or NET-EN in South Africa.
- Blood and genital tract cells were analyzed via flow cytometry at baseline and 25 weeks.
- Key HIV-1 target cells (CD4+ cells) and their markers were quantified.
Main Results:
- Both contraceptives similarly affected systemic CD4+ cells.
- DMPA-IM and NET-EN showed differential effects on female genital tract cell populations.
- DMPA-IM use was associated with increased FGT target cells, particularly after accounting for non-study progestin use.
Conclusions:
- DMPA-IM and NET-EN have minimal systemic effects but differential impacts on FGT HIV target cells.
- DMPA-IM use may be associated with increased HIV-1 acquisition risk in the FGT compared to NET-EN.
- Further research is needed to understand the clinical implications of these findings.
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