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How does hormonal contraception affect HIV therapy?



Unanswered questions about how contraceptive hormones interact with the immune system and with antiretroviral (ARV) drugs have raised concerns about the response to ARV therapy among HIV-infected women using hormonal contraception.

Until recently, no research had addressed these concerns. But one study, conducted among 154 HIV-infected women participating in the largest prospective study of the impact of HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States.  infection on U.S. women, found that hormonal contraceptive use did not reduce the effectiveness of the combinations of three or more different ARV drugs known as highly active antiretroviral therapy Noun 1. highly active antiretroviral therapy - a combination of protease inhibitors taken with reverse transcriptase inhibitors; used in treating AIDS and HIV
drug cocktail, HAART
 (HAART HAART highly active antiretroviral therapy.
HAART Highly active antiretroviral therapy, triple combination therapy AIDS The concurrent administration of 2 nucleoside reverse transcriptase inhibitors–eg, AZT and 3TC, and a protease
). (1)

Researchers compared the effects of HAART among 77 hormonal contraceptive users and 77 non-users participating in the Women's Interagency HIV Study The Women's Interagency HIV Study (WIHS) is a program created in August 1993 "to investigate the impact of HIV on women in the U.S." [1] The study focuses on the unique issues of women's health as it is effected by the AIDS epidemic.  (WIHS WIHS AIDS A clinical trial–Women's Interagency HIV Study ). Members of the two groups were matched for age, ethnicity, and pretreatment pretreatment,
n the protocols required before beginning therapy, usually of a diagnostic nature; before treatment.

pretreatment estimate,
n See predetermination.
 measures of HIV disease progression (the number of CD4+ immune system cells per cubic millimeter of blood and the level of HIV in the blood).

[ILLUSTRATION OMITTED]

The analysis revealed no statistically significant differences in immunologic or virologic responses to therapy between women who had been using hormonal contraceptives when they began HAART and non-users. Similar percentages of women in both groups experienced increases in CD4+ cell counts and decreases in viral load to undetectable levels. Moreover, the duration of hormonal contraceptive use before HAART initiation did not affect these positive responses to the therapy.

"The relatively low use of hormonal contraception among WIHS participants limited the statistical power of our study, and therefore our ability to detect very small effects on treatment response," cautions Dr. Stephen Gange, an author of the study, WIHS principal investigator, and associate professor of epidemiology at Johns Hopkins University Johns Hopkins University, mainly at Baltimore, Md. Johns Hopkins in 1867 had a group of his associates incorporated as the trustees of a university and a hospital, endowing each with $3.5 million. Daniel C.  Bloomberg School of Public Health, Baltimore, MD, USA. "We also need additional data to assess whether long-term exposure to hormonal contraceptives influences the effectiveness of ARV therapy."

Reference

(1) Chu J, Gange SJ, Anastos K, et al. Hormonal contraceptive use and the effectiveness of highly active antiretroviral therapy. Am J Epidemiol 2005;161(9):881-90.
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Author:Shears, Kathleen Henry
Publication:Network
Article Type:Clinical report
Date:Jun 22, 2007
Words:325
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