ArticleFrontiers in immunology2025
No change in key HIV target cell markers following initiation of three progestin-based hormonal contraception methods: findings from the CHIME study.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Depot medroxyprogesterone acetate (DMPA) injectable, etonogestrel subdermal implant (ENG-implant), and levonorgestrel intrauterine device (LNG-IUD) are effective, widely used female hormonal contraceptives (HC). Observational studies, but not a randomized trial, suggest increased risk of HIV acquisition with HC use, particularly DMPA. Sexual acquisition of HIV occurs via CD4+ T cells expressing C-C chemokine receptor type 5 (CCR5), though other immunologic cells play a role. This study examined longitudinal changes in CCR5+ T cells and other immunologic cells in the female genital tract following HC initiation. Methods: HIV negative participants aged 18-45 years, not using HC, were recruited in Atlanta, Georgia. After two pre-HC visits, participants initiated DMPA, ENG-implant, or LNG-IUD and completed visits every three months for one year. Specimens (peripheral blood, endocervical cells, cervical tissue biopsy, and cervicovaginal lavage [CVL]) were analyzed for immune cellular markers (CD45, CD3, CD4, CCR5, CD69, HLA-DR, CD38, α4β7, CD103, Fox-P3, and Ki-67) using flow cytometry. Effects of CVL on HIV infection of cells Results: Among 118 participants (mean age 25.9; 44.1% self-identified as Black race), 545 visits were completed from 2019-2023. No significant changes were observed in proportion of CCR5+ T cells in any tissue type post-HC. There were statistically significant but moderate absolute decreases in proportion of CD45+ and CD4+ T cells in CVL, and CD4+ T cells in blood, and increased proportion of CD69+ T cells in blood post-HC. Post-HC CVL vs. pre-HC enhanced HIV infection of cells Discussion: Our findings suggest that commonly used HC methods do not result in immunologic changes that increase HIV acquisition risk. However, HIV infection enhancement with post-HC CVL
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