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Menstrual Cycle Affects Shedding of HIV in Cervical Secretions
  (Reuters Health, June 14, 2004). The level of HIV RNA in cervical secretions varies during the menstrual cycle, peaking as menses approaches, according to a report in the June 15th issue of The Journal of Infectious Diseases.
Although cross-sectional studies have suggested a potential association between cyclicfluctuations in endogenous hormone levels during the menstrual cycle and shedding of HIVin genital secretions, the authors point out, studies examining mucosal virus levels atdifferent times during the menstrual cycle have yielded conflicting results.
To investigate further, Dr. Julie Overbaugh from Fred Hutchinson Cancer Research Center,Seattle and colleagues used a highly sensitive HIV RNA assay to measure HIV levels invaginal and cervical swab specimens obtained daily for the duration of one menstrualcycle in 17 HIV-1-seropositive women untreated with antiretroviral drugs. Serum samples forHIV RNA assay were collected three times a week during the study.
HIV RNA in vaginal secretions correlated with serum HIV RNA, but not with hormone levels.HIV RNA in cervical secretions was also highly correlated with serum virus load, the authorsreport, but cervical levels of HIV RNA were inversely correlated with serum levels ofestradiol.
The level of HIV RNA in cervical secretions gradually decreased until the luteinizinghormone surge and then gradually increased before the start of the next menses.
The observed fluctuations in virus levels, the researchers conclude, "suggest thatreproductive hormones can affect the level of virus production or the number ofproductively infected cells within the genital mucosa."
This, they add, "also implies there may be more risk of transmission of HIV-1 at certain timesduring the menstrual cycle."


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