ArticleNature medicine2018
Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women.
Article in Nature medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
105 citing papers in PubMed, 141 citations in OpenAlex.
- Vaginal Microbiota and Cytokines Among Pregnant and Breastfeeding Women in Clinical Trials of the Dapivirine Vaginal Ring and Oral Tenofovir Disoproxil Fumarate/Emtricitabine.Open forum infectious diseases · 2026Trial
- Trial
- Genital microbiota of women using a 90 day tenofovir or tenofovir and levonorgestrel intravaginal ring in a placebo controlled randomized safety trial in Kenya.Scientific reports · 2022Trial
- Higher mucosal antibody concentrations in women with genital tract inflammation.Scientific reports · 2021Trial
- Transient association between semen exposure and biomarkers of genital inflammation in South African women at risk of HIV infection.Journal of the International AIDS Society · 2021Trial
- Comparison of Female Genital Tract Cytokine and Microbiota Signatures Induced by Initiation of Intramuscular DMPA and NET-EN Hormonal Contraceptives - a Prospective Cohort Analysis.Frontiers in immunology · 2021Trial
- Testing the regulatory framework in South Africa - a single-blind randomized pilot trial of commercial probiotic supplementation to standard therapy in women with bacterial vaginosis.BMC infectious diseases · 2020Trial
- Live attenuated varicella-zoster virus vaccine does not induce HIV target cell activation.The Journal of clinical investigation · 2019Trial
- Using safe, affordable and accessible non-steroidal anti-inflammatory drugs to reduce the number of HIV target cells in the blood and at the female genital tract.Journal of the International AIDS Society · 2018Trial
- Cervicovaginal microbiome diversity was not associated with mucosal pharmacokinetics of systemically delivered HIV broadly neutralizing antibodies.Scientific reports · 2026Article
- Preclinical Toxicological evaluation of the HIV entry inhibitor peptide 2P23 as a candidate rectovaginal microbicide.Scientific reports · 2026Article
- CD11c+ myeloid cells are the predominant CD4+CCR5+ immune population in the foreskin and are increased in men with HIV-associated penile anaerobes.bioRxiv : the preprint server for biology · 2026Article
- Mucosal Dynamics Contributing to Innate Immune Responses to HIV in the Human Female Genital Tract.Viruses · 2026Review
- Tenofovir, Interferon Pathways, and Mucosal Immunity: Implications for People Living With HIV.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Innate Immune Protection Against HIV in the Female Genital Tract.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Impact of Tenofovir Alafenamide Sub-Dermal Implant Insertion Site Scarring on Acceptability and HIV Prevention Preferences: A Prospective Cohort Study in Durban, South Africa.Journal of the International AIDS Society · 2026Observational
- Mucosal tenofovir 1% gel stimulates cell proliferation and type I/III interferon pathways.Microbiology spectrum · 2026Article
- Association of human papillomavirus on risk of HIV acquisition in African women: analyses from MTN-020/ASPIRE.Journal of the National Cancer Institute · 2026Article
- Evaluating theFrontiers in immunology · 2026Article
- Assessing Inflammatory Biomarkers at the Intersection of Marijuana and PrEP Use: Preliminary Findings From the NCHAT-BIO Study.Journal of acquired immune deficiency syndromes (1999) · 2025Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 3 countries.
Funding
Abstract
Several clinical trials have demonstrated that antiretroviral (ARV) drugs taken as pre-exposure prophylaxis (PrEP) can prevent HIV infection, with the magnitude of protection ranging from -49 to 86% (refs. ). Although these divergent outcomes are thought to be due primarily to differences in product adherence, biological factors likely contribute. Despite selective recruitment of higher-risk participants for prevention trials, HIV risk is heterogeneous even within higher-risk groups. To determine whether this heterogeneity could influence patient outcomes following PrEP, we undertook a post hoc prospective analysis of results from the CAPRISA 004 trial for 1% tenofovir gel (n = 774 patients), one of the first trials to demonstrate protection against HIV infection. Concentrations of nine proinflammatory cytokines were measured in cervicovaginal lavages at >2,000 visits, and a graduated cytokine score was used to define genital inflammation. In women without genital inflammation, tenofovir was 57% protective against HIV (95% confidence interval (CI): 7-80%) but was 3% protective (95% CI: -104-54%) if genital inflammation was present. Among women who highly adhered to the gel, tenofovir protection was 75% (95% CI: 25-92%) in women without inflammation compared to -10% (95% CI: -184-57%) in women with inflammation. Immunological predictors of HIV risk may modify the effectiveness of tools for HIV prevention; reducing genital inflammation in women may augment HIV prevention efforts.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.