HIV This Week

Benki S, Mostad SB, Richardson BA, Mandaliya K, Kreiss JK, Overbaugh J. Increased Levels of HIV-1-Infected Cells in Endocervical Secretions After the Luteinizing Hormone Surge. J Acquir Immune Defic Syndr. 2008 Jan 17; Epub ahead of print.

Levels of HIV-1 RNA in endocervical specimens fluctuate with the menstrual cycle, suggesting that cell-free HIV-1 levels may vary during the cycle, which could influence infectivity. Here, Benki and colleagues examined daily changes in endocervical HIV-1-infected cells during 1 cycle. There were significant positive associations between the number of days from the luteinizing hormone surge and the number of HIV-1 DNA copies/swab (P = 0.001) and the number of total cells/swab (P < 0.001) in endocervical specimens. These data suggest that sampling of cell-associated endocervical HIV-1 increases after the periovulatory period, which could result in increased exposure to HIV-1-infected cells during sexual contact.

Editors’ note: This quantitative analysis of endocervical HIV-1-infected cell levels during the menstrual cycle is a first. Although there is a possibility that the differences seen could be due to changes in the level of endocervical secretions during the menstrual cycle rather that a direct effect of hormonal changes in the luteal phase (second half of the menstrual cycle), the finding that cell-free and cell-associated virus increase as menses is approaching is clear. It is therefore likely that pre-menopausal women are more infectious following the luteinising hormone surge which occurs around ovulation.