Cyclic changes in HIV shedding from the female genital tract during the menstrual cycle

Marcel E. Curlin, Wanna Leelawiwat, Eileen F. Dunne, Wannee Chonwattana, Philip A. Mock, Famui Mueanpai, Sukhon Thep-Amnuay, Sara J. Whitehead, Janet M. McNicholl

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Factors increasing genital human immunodeficiency virus (HIV) shedding may increase female-to-male HIV transmission risk. We examined HIV shedding in 67 women with HIV type 1 and herpes simplex virus type 2 coinfection, during 2 menstrual cycles. Shedding occurred in 60%, 48%, and 54% of samples during the follicular, periovulatory, and luteal phases, respectively (P =. 01). Shedding declined after menses until ovulation, with a slope-0.054 log10 copies/swab/day (P <. 001), corresponding to a change of approximately 0.74 log10 copies between peak and nadir levels. Shedding increased during the luteal phase only among women with CD4 counts of <350 cells/μL. In reproductive-aged women, shedding frequency and magnitude are greatest immediately following menses and lowest at ovulation.

Original languageEnglish (US)
Pages (from-to)1616-1620
Number of pages5
JournalJournal of Infectious Diseases
Issue number10
StatePublished - May 15 2013
Externally publishedYes


  • HIV
  • Thailand
  • female
  • genital tract
  • menstrual cycle
  • mucosal
  • shedding
  • transmission

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases


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