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. Author manuscript; available in PMC: 2012 May 1.
Published in final edited form as: J Acquir Immune Defic Syndr. 2012 May 1;60(1):99–110. doi: 10.1097/QAI.0b013e31824aeaaa

Table 5.

Association of Demographic, Behavioral, Virologic, and Clinical Factors with HIV-1 Genital Longitudinal Shedding Pattern Among 136 Participants with 3 or More Visits.a

HIV-1 genital shedding categoryc Univariate modelsd Models adjusted for ART and PVLe
Factorb Never
Shedderi
(N=55)		 Intermittent
Shedderi
(N=61)		 Persistent
Shedderi
(N=20)		 OR (95% CI) P OR (95% CI) P
Antiretroviral therapy
      No therapy 14 (25) 22 (36) 13 (65) Ref Ref
      Mono/Combo 11 (20) 13 (21) 2 (10) 0.42 (0.17–1.05) 0.07 0.63 (0.23–1.67) 0.35
      HAART 30 (55) 26 (43) 5 (25) 0.34 (0.16–0.72) 0.005 0.50 (0.21–1.19) 0.12
Plasma HIV-1 RNA level, copies/mL
      ≤400 25 (49) 18 (31) 1 (5) Ref Ref
      401–3,999 14 (27) 12 (20) 2 (10) 1.39 (0.55–3.53) 0.48 1.00 (0.36–2.81) 0.99
      4,000–19,999 8 (16) 9 (15) 3 (15) 2.36 (0.82–6.74) 0.11 2.01 (0.69–5.87) 0.20
      ≥20,000 4 (8) 20 (34) 14 (70) 11.65 (4.45–30.53) <0.001g 8.87 (3.21–24.54) <0.001g
      Unknown 4 2 0
      Per log10 increase 2.64(1.84–3.80) <0.001 2.47 (1.70–3.60) <0.001
CD4 cell count, cells/mm3
      0–200 6 (11) 10 (17) 8 (40) 5.67 (2.09–15.37) 0.001g 2.49 (0.79–7.88) 0.12
      201–350 13 (24) 18 (30) 7 (35) 2.86 (1.24–6.60) 0.01 2.34 (0.92–5.93) 0.07
      351–500 9 (16) 14 (23) 3 (15) 2.41 (0.96–6.01) 0.06 2.58 (0.96–6.90) 0.06
      >500 27 (49) 18 (30) 2 (10) Ref Ref
      Unknown 0 1 0
Alcohol consumption
      Abstainer 31 (56) 32 (53) 5 (25) Ref Ref
      Light (<3 drinks/week) 11 (20) 16 (27) 5 (25) 1.68 (0.76–3.71) 0.20 2.58 (1.05–6.34) 0.04
      Moderate (3–13 drinks/week) 8 (15) 7 (12) 2 (10) 1.04 (0.38–2.87) 0.94 1.10 (0.36–3.32) 0.87
      Heavy (14 or more drinks/week) 5 (9) 5 (8) 8 (40) 4.69 (1.60–13.76) 0.005h 3.29 (1.10–9.79) 0.03
      Any 24 (43.6) 28 (46.7) 15 (75.0) 1.86 (0.98–3.56) 0.06 2.20 (1.08–4.49) 0.03
      Unknown 0 1 0
Cervical friability
      Absent 41 (87) 55 (95) 19 (100) Ref Ref
      Present 6 (13) 3 (5) 0 (0) 0.26 (0.06–1.04) 0.06 0.20 (0.03–1.20) 0.08
      Unknown 8 3 1
Herpes simplex virus type 2
      Absent 18 (33.3) 14 (24.1) 2 (10.0) Ref Ref
      Present 36 (66.7) 44 (75.9) 18 (90.0) 2.13 (1.01–4.52) 0.05 3.21 (1.34–7.67) 0.009
      Unknown 1 3 0
Human papillomavirus, all types
      Absent 25 (61) 23 (49) 2 (15) Ref Ref
      Present 16 (39) 24 (51) 11 (85) 2.70 (1.25–5.83) 0.01 2.00 (0.83–4.81) 0.12
      Unknown 14 14 7
Trichomonas vaginalis
      Absent 51 (93) 57 (93) 15 (75) Ref Ref
      Present 4 (7) 4 (7) 5 (25) 2.75 (0.87–8.75) 0.09 1.37 (0.38–4.93) 0.63
Summary variable over all visitsf
Use of HAART
      Never 12 (22) 14 (23) 7 (35) Ref Ref
      Intermittent 21 (38) 36 (59) 12 (60) 1.09 (0.49–2.42) 0.84 1.57 (0.67–3.70) 0.30
      Continuous 22 (40) 11 (18) 1 (5) 0.26 (0.10–0.69) 0.006h 0.46 (0.16–1.30) 0.14
Detectable plasma HIV-1 RNA
      Always 20 (36) 24 (39) 18 (90) Ref Ref
      Sometimes 16 (29) 32 (52) 2 (10) 0.54 (0.26–1.11) 0.09 0.48 (0.23–1.02) 0.06
      Never 19 (35) 5 (8) 0 (0) 0.09 (0.03–0.27) <0.001 0.10 (0.03–0.32) <0.001

NOTE. Data are no. (%) of population, unless otherwise indicated. Boldface type indicates statistical significance. ART, antiretroviral therapy; CI, confidence interval; HAART, highly active antiretroviral therapy; Ref, reference.

a

Data is restricted to participants with a minimum of 3 and a maximum of 6 evaluated consecutive visits; only at most 1 consecutive visit can be skipped.

b

All factors were evaluated but only those with associations where P<0.10 in univariate or adjusted models are included in the table.

c

Genital shedding is defined as HIV RNA in CVL > 80 copies/mL. Shedding categories are defined as: never shedder, shed at 0 visits; intermittent, shed at 1 or 2 visits; and persistent shedder, shed at 3 or more visits.

d

Ordinal logistic regressions are used to estimate odds ratios, 95% confidence intervals and P-values where data from the first evaluated visit contributes to the model.

e

Adjusted models control for ART category (no therapy, mono/combo, HAART) and plasma HIV-1 RNA level category (≤400, 401–3999, 4000–19999, 20000+ copies/mL). The ART model is adjusted for plasma HIV-1 RNA level only, and the plasma HIV-1 RNA level model is adjusted for ART only.

f

The adjusted model for use of HAART adjusts only for PVL. The adusted model for Detectable plasma HIV-1 RNA adjusts only for ART.

g

P-trend<0.001;

h

P-trend<0.01.

i

Proportionality odds assumption was met for increasing shedding frequency by likelihood ratio test for all variables but Friability and Detectable plasma HIV-1 RNA. These are not reliable due to presence of 0.