Do Hormonal Contraceptives Effect Anti-Viral Medications?

By ParentingPatch (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

Women account for almost half of all individuals living with HIV all over the world, and researchers sought to identify the risk factors that made them more susceptible to the virus through genital infections.

The HIV Study

Because the Human Immunodeficiency Virus (HIV) and other sexually transmitted viral infections must penetrate the genital mucosal barrier to establish infection, researchers at the Ohio State University Wexner Medical Center wished to identify the factors which weaken the genital mucosal barrier defenses.
The research, which was recently published in the journal of Mucosal Immunology, shows significantly increased risk of female mice to genital tract viral infections after treatment with depot medroxyprogestronate acetate or DMPA or LNG, two injectable compounds used by females as hormonal contraception.

Specifically, the treatment of mice with DMPA or LNG decreased the barrier protection in the female genital tract by increasing the permeability of the epithelium. Because of greater permeability, there is a greater chance that a viral pathogen could invade and cause an infection.

Dr. Thomas L. Cherpes, an associate professor in the Departments of Microbial Infection and Immunity and Obstetrics and Gynecology at the Ohio State University College of Medicine, “Our findings provide new biological plausibility for the connection between DMPA and increased susceptibility to genital infection suggested by many clinical studies. They also identify that LNG may similarly enhance susceptibility to viral infections.”

Dr. Nirk Quispe Calla, a lead author of the publication said, “Remarkably, our evaluation of cervical biopsy tissue from women before and one month after initiating DMPA, revealed barrier protection was dismissed by treatment identically to the change seen in progestin-treated mice.”

On the other hand, there were additional mouse studies performed by the team which showed that combined treatment with DMPA and intravaginal estrogen prevented mice from acquiring herpes simplex virus type 2, by restoring the genital mucosal barrier, the first line of defense against all types of sexually transmitted infections.

Based on the results of the latter studies, Cherpes stated the ability to rescue DMPA-treated mice with local estrogen administration may offer a groundwork for the advancement of contraceptive approaches less compromising of barrier protection, as use of an estradiol-releasing vaginal delivery could be combined into approaches for hormonal contraception.

Conclusion to the Study

Dr. Rodolfo Vicetti Miguel, another author of the study stated, “In one possible scenario, women would receive DMPA and an estradiol-releasing vaginal ring that also releases antiviral microbicides. While only a hypothetical alternative at this time, defining the safety and efficacy of such an approach warrants further study.”

Other investigative researchers involved with the study included Dr. Luanne Hall-Stoodley, Dr. Balveen Kaur and Dr. Wayne Trout and undergraduate researcher Stephen Paveiko.

Funding and support for the study was provided by the Eunice Kennedy Shriver Institute for Child Health and Human Development.


 
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