Evidence map›Paper›PMID 35941737›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Initiating Intramuscular Depot Medroxyprogesterone Acetate Increases Frequencies of Th17-like Human Immunodeficiency Virus Target Cells in the Genital Tract of Women in South Africa: A Randomized Trial.

Rubina Bunjun, Tanko F Ramla, Shameem Z Jaumdally, Laura Noël-Romas, Hossaena Ayele, Bryan P Brown, Hoyam Gamieldien, Rushil Harryparsad, Smritee Dabee, Gonasagrie Nair and 10 more

Erratum issued Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT02550067 (A Multi Center, Open-Label, Randomised Clinical Trial Comparing HIV Incidence and Contraceptive Benefits in Women Using Depot Medroxyprogesterone Acetate), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02550067 nacompletednot on this map

A Multi Center, Open-Label, Randomised Clinical Trial Comparing HIV Incidence and Contraceptive Benefits in Women Using Depot Medroxyprogesterone Acetate (DMPA), Levonorgestrel (LNG) Implant, and Copper Intrauterine Devices (IUDs)

TypeinterventionalSponsorFHI 360Ran2015 to 2018Enrolled7,830ConditionsHIV, ContraceptionArmsDMPA, LNG, Copper IUD
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 6 countries.

Rubina BunjunInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-8471-163X
Tanko F RamlaInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Shameem Z JaumdallyInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Laura Noël-RomasCenter for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA.
Hossaena AyeleCenter for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA.
Bryan P BrownSeattle Children's Research Institute, Seattle, Washington, USA.
Hoyam GamieldienInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Rushil HarryparsadInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Smritee DabeeInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Gonasagrie NairDesmond Tutu HIV Foundation (DTHF), Cape Town, South Africa.
Maricianah OnonoKenya Medical Research Institute, Nairobi, Kenya.
Thesla Palanee-PhillipsWits Reproductive Health and HIV Institute (WHRI), Johannesburg, South Africa.
Catilin W ScovilleUniversity of Washington, Seattle, Washington, USA.
Kate B HellerUniversity of Washington, Seattle, Washington, USA.
Jared M BaetenUniversity of Washington, Seattle, Washington, USA.
Steven E BosingerEmory University, Atlanta, Georgia, USA.
Adam BurgenerCenter for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA.
Jo-Ann S PassmoreInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Heather JaspanInstitute of Infectious Disease and Molecular Medicine, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Renee HeffronUniversity of Washington, Seattle, Washington, USA.
University of Cape Town · ZAUniversity of Washington · USCenter for Global Health · USDesmond Tutu HIV Foundation · ZAEmory University · USKarolinska University Hospital · SEKenya Medical Research Institute · KENational Health Laboratory Service · ZA

Funding

Effects of Hormonal Contraceptives on Genital Immunity and HIV SusceptibilityR01HD089831 · NICHD · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A., JASPAN, HEATHER BERYL · 2016 to 2020
$3.0M
NICHD NIH HHS R01 HD089831
6 · The paper itself

Abstract

backgroundCervicovaginal CD4+ T cells are preferential targets for human immunodeficiency virus (HIV) infection and have consequently been used as a proxy measure for HIV susceptibility. The ECHO randomized trial offered a unique opportunity to consider the association between contraceptives and Th17-like cells within a trial designed to evaluate HIV risk. In a mucosal substudy of the ECHO trial, we compared the impact of initiating intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper-IUD, and the levonorgestrel (LNG) implant on cervical T cells.

methodsCervical cytobrushes from 58 women enrolled in the ECHO trial were collected at baseline and 1 month after contraceptive initiation. We phenotyped cervical T cells using multiparameter flow cytometry, characterized the vaginal microbiome using 16s sequencing, and determined proteomic signatures associated with Th17-like cells using mass spectrometry.

resultsUnlike the LNG implant or copper-IUD, DMPA-IM was associated with higher frequencies of cervical Th17-like cells within 1 month of initiation (P = .012), including a highly susceptible, activated population co-expressing CD38, CCR5, and α4β7 (P = .003). After 1 month, women using DMPA-IM also had more Th17-like cells than women using the Cu-IUD (P = .0002) or LNG implant (P = .04). Importantly, in women using DMPA-IM, proteomic signatures signifying enhanced mucosal barrier function were associated with the increased abundance of Th17-like cells. We also found that a non-Lactobacillus-dominant microbiome at baseline was associated with more Th17-like cells post-DMPA-IM (P = .03), although this did not influence barrier function.

conclusionsOur data suggest that DMPA-IM-driven accumulation of HIV-susceptible Th17-like cells might be counteracted by their role in maintaining mucosal barrier integrity. CLINICAL TRIALS REGISTRATION: NCT02550067.

Indexed as

Contraceptive Agents, FemaleHIV InfectionsCopperDisease SusceptibilityFemaleHIVHumansLevonorgestrelMedroxyprogesterone AcetateProteomicsSouth AfricaVaginaContraceptive Agents, FemaleCopperLevonorgestrelMedroxyprogesterone AcetateHIV riskhormonal contraceptionmucosal barrier integrityTh17 cells

Identifiers

PMID35941737
PMCPMC9710690
OpenAlexW4290739295

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.