Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells
CM Mitchell, L McLemore, K Westerberg… - The Journal of …, 2014 - academic.oup.com
CM Mitchell, L McLemore, K Westerberg, R Astronomo, K Smythe, C Gardella, M Mack…
The Journal of infectious diseases, 2014•academic.oup.comBackground. Depot medroxyprogesterone acetate (DMPA) has been linked to human
immunodeficiency virus type 1 (HIV-1) acquisition. Methods. Vaginal microbiota of women
using DMPA for up to 2 years were cultured. Mucosal immune cell populations were
measured by immunohistological staining. Results. Over 12 months, the proportion with
H2O2-positive lactobacilli decreased (n= 32; 53% vs 27%; P=. 03). Median vaginal CD3+
cells also decreased (n= 15; 355 vs 237 cells/mm2; P=. 03), as did CD3+ CCR5+ cells (195 …
immunodeficiency virus type 1 (HIV-1) acquisition. Methods. Vaginal microbiota of women
using DMPA for up to 2 years were cultured. Mucosal immune cell populations were
measured by immunohistological staining. Results. Over 12 months, the proportion with
H2O2-positive lactobacilli decreased (n= 32; 53% vs 27%; P=. 03). Median vaginal CD3+
cells also decreased (n= 15; 355 vs 237 cells/mm2; P=. 03), as did CD3+ CCR5+ cells (195 …
Abstract
Background. Depot medroxyprogesterone acetate (DMPA) has been linked to human immunodeficiency virus type 1 (HIV-1) acquisition.
Methods. Vaginal microbiota of women using DMPA for up to 2 years were cultured. Mucosal immune cell populations were measured by immunohistological staining.
Results. Over 12 months, the proportion with H2O2-positive lactobacilli decreased (n = 32; 53% vs 27%; P = .03). Median vaginal CD3+ cells also decreased (n = 15; 355 vs 237 cells/mm2; P = .03), as did CD3+CCR5+ cells (195 vs 128 cells/mm2; P = .04), HLA-DR+ cells (130 vs 96 cells/mm2; P = .27), and HLA-DR+CCR5+ cells (18 vs 10 cells/mm2; P = .33).
Conclusions. DMPA contraception does not increase vaginal mucosal CCR5+ HIV target cells but does decrease CD3+ T lymphocytes and vaginal H2O2-producing lactobacilli.
Oxford University Press