Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells

J Infect Dis. 2014 Aug 15;210(4):651-5. doi: 10.1093/infdis/jiu176. Epub 2014 Mar 20.

Abstract

Background: Depot medroxyprogesterone acetate (DMPA) has been linked to human immunodeficiency virus type 1 (HIV-1) acquisition.

Methods: Vaginal microbiota of women using DMPA for up to 2 years were cultured. Mucosal immune cell populations were measured by immunohistological staining.

Results: Over 12 months, the proportion with H2O2-positive lactobacilli decreased (n = 32; 53% vs 27%; P = .03). Median vaginal CD3(+) cells also decreased (n = 15; 355 vs 237 cells/mm(2); P = .03), as did CD3(+)CCR5(+) cells (195 vs 128 cells/mm(2); P = .04), HLA-DR(+) cells (130 vs 96 cells/mm(2); P = .27), and HLA-DR(+)CCR5(+) cells (18 vs 10 cells/mm(2); P = .33).

Conclusions: DMPA contraception does not increase vaginal mucosal CCR5(+) HIV target cells but does decrease CD3(+) T lymphocytes and vaginal H2O2-producing lactobacilli.

Keywords: HIV; medroxyprogesterone acetate; vaginal mucosa.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Drug Implants
  • Epithelium / drug effects
  • Epithelium / immunology
  • Epithelium / microbiology
  • Epithelium / virology
  • Female
  • HIV Infections / immunology*
  • HIV-1 / physiology*
  • Humans
  • Medroxyprogesterone Acetate / administration & dosage*
  • Medroxyprogesterone Acetate / adverse effects*
  • Microbiota / drug effects*
  • Microbiota / immunology
  • Mucous Membrane / drug effects
  • Mucous Membrane / immunology
  • Mucous Membrane / virology
  • Vagina / drug effects*
  • Vagina / immunology
  • Vagina / microbiology*
  • Vagina / virology
  • Young Adult

Substances

  • Antineoplastic Agents, Hormonal
  • Drug Implants
  • Medroxyprogesterone Acetate