Variation of human immunodeficiency virus type 1 viral RNA levels in the female genital tract: Implications for applying measurements to individual women

The short-term detection and variability of human immunodeficiency virus ty pe 1 (HIV-1) RNA level was assessed in the blood plasma and genital tracts of 55 HIV-1-infected women. Specimens were collected weekly for 8 weeks fro m the endocervical canal with wicks and cytobrushes and from the ectocervix and vagina with cervicovaginal lavage. In all, 48 women (87.3%) had detect able genital tract HIV-1 RNA at greater than or equal to1 collection times. HIV-1 RNA levels varied least in specimens from endocervical canal wick an d most in cervicovaginal lavage samples. The within-subject variation for g enital-tract virus level was greater than that for blood. Overall, the odds for viral RNA detection in the genital tract approximately tripled for eac h 10-fold increase in plasma viral RNA concentration (P < .001) or with con comitant genital tract infection (P = .003). Endocervical canal wicks shoul d be considered as an adjunct to cervicovaginal lavage, to improve the sens itivity and precision of HIV-1 RNA detection.