HIV/AIDS & STDs – HAART not affected by hormonal contraceptives

December 25, 2005 at 5:50 pm Leave a comment

Source: Infectious Disease News – June 2005

No association found between hormonal birth control use and CD4+ cell count or viral load suppression after HAART initiation.

by Tara Grassia – Staff Writer

Estrogen and progesterone hormones in contraceptives do not influence the effectiveness of highly active antiretroviral therapy (HAART), according to a recent study.

Researchers at the Johns Hopkins Bloomberg School of Public Health and other institutions investigated the possible influence of hormonal contraceptive use on CD4+ cell count and viral load and its response to HAART.

“Our main conclusion was that we did not find an association between hormonal contraceptive use and changes in CD4+ cell count or time to viral load suppression after initiation of HAART,? said Stephen J. Gange, PhD, a study researcher and an associate professor in the department of epidemiology at the Bloomberg School of Public Health.

Gange and colleagues also did not find any connection between those outcomes and the duration of hormonal contraception use before HAART initiation.

“From a public health perspective, our findings alleviate concerns regarding suspected negative effects of hormonal contraceptive use on the response to HAART,? he told Infectious Disease News.

Contraceptive’s connection

Researchers examined the role of hormonal contraceptive usage and the effectiveness of HAART among 77 contraception users and 77 nonusers, using data collected from the Women’s Interagency HIV Study (WIHS). WIHS is a large, ongoing cohort study of about 3,700 women living with HIV and high-risk women in the United States, said Gange, also principal investigator of WIHS.

Of the hormonal contraceptive users, 64% took oral contraceptives and 27% used depomedroxy progesterone acetate (Depo-Provera, Pfizer). The remaining participants used Norplant (Wyeth) or a combination, Gange said.

Researchers matched participants according to age, race and pre-HAART CD4+ cell counts and viral load, and followed them from onset of HAART initiation. Hormonal contraceptive use or nonuse and cell count and viral load response to HAART were all compared.

The researchers did not find a “statistically significant difference in CD4+ cell counts and log viral load responses by hormone use after HAART initiation,? according to the study. No relationship between those outcomes and the duration of hormonal contraception use before HAART initiation was found.

“The study results also reinforce the strong effects of HAART on HIV-disease progression,? he said. Women who used HAART continuously were almost three times more likely to experience a CD4+ cell count increase of 50 cells/mm3, over 3.5 times more likely to achieve a CD4+ cell count increase of 100 cells/mm3 and approximately 2.7 times more likely to achieve an undetectable viral load than contraceptive nonusers.

Gange and colleagues recommended follow-up data collection in the future in order to assess the effects of potential long-term exposure to hormonal contraceptives.

For more information:
Chu JH, Gange SJ, Anastos K, et al. Hormonal contraceptive use and the effectiveness of highly active antiretroviral therapy. Am J of Epidemiol. 2005;161:881-890.

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Entry filed under: HIV/SIDA HAART, HIV/SIDA Mujeres.

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