Feasibility and Safety of Cervical Biopsy Sampling for Mucosal Immune Studies in Female Sex Workers from Nairobi, Kenya 英文参考文献.docVIP

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Feasibility and Safety of Cervical Biopsy Sampling for Mucosal Immune Studies in Female Sex Workers from Nairobi, Kenya 英文参考文献.doc

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Feasibility and Safety of Cervical Biopsy Sampling for Mucosal Immune Studies in Female Sex Workers from Nairobi, Kenya 英文参考文献

FeasibilityandSafetyofCervicalBiopsySamplingfor MucosalImmuneStudiesinFemaleSexWorkersfrom Nairobi,Kenya KlaraHasselrot1,JulianaCheruiyot2,JoshuaKimani2,TerryB.Ball3,4,RupertKaul2,5,TahaHirbod1,5 * 1Department of Medicine, Unit of Infectious Diseases, Center for Molecular Medicine, Karolinska University Hospital/Karolinska Institutet, Stockholm, Sweden, 2DepartmentofMedicalMicrobiology,UniversityofNairobi,Nairobi,Kenya,3DepartmentsofImmunologyandMedicalMicrobiology,UniversityofManitoba,Winnipeg, Manitoba,Canada,4NationalHIVandRetrovirologyLaboratories,PublichealthAgencyofCanada,Ottawa,Ontario,Canada,5DepartmentsofMedicineandImmunology, UniversityofToronto,Ontario,Canada Abstract Background: There is an urgent need to improve our understanding of the mucosal immuno-pathogenesis of HIV acquisitioninthefemalegenitaltract,particularlyinhigh-riskwomensuchasfemalesexworkers(FSWs).Cervicalbiopsy samples offer technical advantages over cytobrush sampling, but there are concerns that this might increase HIV acquisition,particularlyifhealingisslowand/orwomendonotabstainfromsexduringhealing. Methodology/PrincipalFindings:Cervicalbiopsysamplesandcervico-vaginalswabsforco-infectiondiagnostics,prostate specific antigen (PSA) and immune studies were collected from 59 women, including HIV seropositive and HIV-exposed seronegative (HESN) FSWs as well as lower risk women from Nairobi, Kenya. A clinical-demographic questionnaire was administeredandwomenwereinstructedtoavoidsexualintercourse,douchingandtheinsertionoftamponsfor14days. All participants underwent a repeat exam to assess healing within the 14 days, and had HIV diagnostics at six months. Cervicalsamplingwaswelltolerated,and82%ofparticipantshadhealedmacroscopicallyby5days.Bothself-reportand PSA screening suggested high levels of compliance with pre- and post-procedure abstinence. Delayed healing was associatedwithvulvovaginalcandidiasis(VVC)andHESNstatus.Atsix-monthfollowupalllow-riskandHESNparticipants remainedHIVseronega