Hormonal contraceptive use and response to antiretroviral therapy among adolescent females

Johnson, Derek C.; Kempf, Mirjam-Colette; Wilson, Craig M.; Shrestha, Sadeep

doi:10.1016/j.hivar.2011.05.002

Cited by 3 publications

(2 citation statements)

References 24 publications

(31 reference statements)

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“…However, in P 4 -treated cells, a significant increase in HIV-1 p24 levels were noted (Fig. 5) for HIV-1 or HIV-1/HSV-2 co-infections, which is in agreement with earlier observations that hormonal contraceptive users had lower viral load reduction than non-contraceptive users (Johnson et al 2011).…”

Section: Discussionsupporting

confidence: 91%

Progesterone augments cell susceptibility to HIV-1 and HIV-1/HSV-2 co-infections

Ragupathy

Wang

Tan

et al. 2016

Journal of Molecular Endocrinology

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In human immunodeficiency virus type 1 (HIV-1)-infected women, oral or injectable progesterone containing contraceptive pills may enhance HIV-1 acquisition in vivo, and the mechanism by which this occurs is not fully understood. In developing countries, Herpes simplex virus type-2 (HSV-2) co-infection has been shown to be a risk for increase of HIV-1 acquisition and, if co-infected women use progesterone pills, infections may increase several fold. In this study, we used an in vitro cell culture system to study the effects of progesterone on HIV-1 replication and to explore the molecular mechanism of progesterone effects on infected cells. In our in vitro model, CEMss cells (lymphoblastoid cell line) were infected with either HIV-1 alone or co-infected with HSV-2. HIV-1 viral load was measured with and without sex hormone treatment. Progesterone-treated cells showed an increase in HIV-1 viral load (1411.2 pg/mL) compared with cells without progesterone treatment (993.1 pg/mL). Increased cell death was noted with HSV-2 co-infection and in progesterone-treated cells. Similar observations were noted in peripheral blood mononuclear cells (PBMC) cells derived from three female donors. Progesterone-treated cells also showed reduced antiviral efficacy. Inflammatory cytokines and associations with biomarkers of disease progression were explored. Progesterone upregulated inflammatory cytokines and chemokines conversely and downregulated anti-apoptotic Bcl-2 expression. Nuclear protein analysis by electrophoretic mobility shift assay showed the association of progesterone with progesterone response element (PRE), which may lead to downregulation of Bcl-2. These data indicate that progesterone treatment enhances HIV-1 replication in infected cells and co-infection with HSV-2 may further fuel this process.

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Section: Discussionsupporting

confidence: 91%

Progesterone augments cell susceptibility to HIV-1 and HIV-1/HSV-2 co-infections

Ragupathy

Wang

Tan

et al. 2016

Journal of Molecular Endocrinology

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“…The efficacy of cART does not appear to be affected by the use of hormonal contraceptive methods on the basis of limited clinical data. 66, 110–114 Very few data are available on whether hormonal contraceptive methods and cART taken together lead to worsening of side effects of contraceptives or increased antiretroviral toxicity. Pharmacokinetic data suggest that COCs, DMPA, and progestin implants are unlikely to have an effect on cART toxicity.…”

Section: Interactions Of Hormonal Contraception and Antiretroviral Drugsmentioning

confidence: 99%

Contraception for HIV-Infected Adolescents

Kourtis¹,

Mirza²

2016

Pediatrics

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Access to high-quality reproductive health care is important for adolescents and young adults with HIV infection to prevent unintended pregnancies, sexually transmitted infections, and secondary transmission of HIV to partners and children. As perinatally HIV-infected children mature into adolescence and adulthood and new HIV infections among adolescentsand young adults continue to occur in the United States, medical providers taking care of such individuals often face issues related to sexual and reproductive health. Challenges including drug interactions between several hormonal methods and antiretroviral agents make decisions regarding contraceptive options more complex for these adolescents. Dual protection, defined as the use of an effective contraceptive along with condoms, should be central to ongoing discussions with HIV-infected young women and couples wishing to avoid pregnancy. Last, reproductive health discussions need to be integrated with discussions on HIV care, because a reduction in plasma HIV viral load below the level of detection (an “undetectable viral load”) is essential for the individual’s health as well as for a reduction in HIV transmission to partners and children.

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Drug interactions between hormonal contraceptives and antiretrovirals

Nanda

Stuart

Robinson³

et al. 2017

Aids

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Objective:To summarize published evidence on drug interactions between hormonal contraceptives and antiretrovirals.Design:Systematic review of the published literature.Methods:We searched PubMed, POPLINE, and EMBASE for peer-reviewed publications of studies (in any language) from inception to 21 September 2015. We included studies of women using hormonal contraceptives and antiretrovirals concurrently. Outcomes of interest were effectiveness of either therapy, toxicity, or pharmacokinetics. We used standard abstraction forms to summarize and assess strengths and weaknesses.Results:Fifty reports from 46 studies were included. Most antiretrovirals whether used for therapy or prevention, have limited interactions with hormonal contraceptive methods, with the exception of efavirenz. Although depot medroxyprogesterone acetate is not affected, limited data on implants and combined oral contraceptive pills suggest that efavirenz-containing combination antiretroviral therapy may compromise contraceptive effectiveness of these methods. However, implants remain very effective despite such drug interactions. Antiretroviral plasma concentrations and effectiveness are generally not affected by hormonal contraceptives.Conclusion:Women taking antiretrovirals, for treatment or prevention, should not be denied access to the full range of hormonal contraceptive options, but should be counseled on the expected rates of unplanned pregnancy associated with all contraceptive methods, in order to make their own informed choices.

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Hormonal contraceptive use and response to antiretroviral therapy among adolescent females

Cited by 3 publications

References 24 publications

Progesterone augments cell susceptibility to HIV-1 and HIV-1/HSV-2 co-infections

Progesterone augments cell susceptibility to HIV-1 and HIV-1/HSV-2 co-infections

Contraception for HIV-Infected Adolescents

Drug interactions between hormonal contraceptives and antiretrovirals

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