Impact of etonogestrel implant use on T-cell and cytokine profiles in the female genital tract and blood

• DOI: 10.1371/journal.pone.0230473
• Publication Date: 2020-03-26T17:35:40Z
• Authors: Lisa B. Haddad; Alison Swaims-Koh...; C. Christina Mehta; Richard E. Haaland; Nakita L. Brown; Anandi N. Sheth; Hsin Chien; Kehmia Titanji; Sharon L. Achilles; Davis Lupo; Clyde E. Hart; Igho Ofotokun
• Keywords: Hormonal contraception; Etonogestrel; Contraceptive implant; Levonorgestrel; Intrauterine device

Background While prior epidemiologic studies have suggested that injectable progestin-based contraceptive depot medroxyprogesterone acetate (DMPA) use may increase a woman's risk of acquiring HIV, recent data DMPA users be at similar for HIV acquisition as the copper intrauterine device and levonorgestrel implant. Use etonogestrel Implant (Eng-Implant) is increasing but there are currently no evaluating its effect on risk. Objective Evaluate potential Eng-Implant by analyzing target cells cytokine profiles in lower genital tract blood adult premenopausal HIV-negative women using Eng-Implant. Methods We prospectively obtained paired cervicovaginal lavage (CVL) samples 4 study visits over 16 weeks from between ages 18–45, with normal menses (22–35 day intervals), uninfected hormonal or (IUD) use, clinical signs sexually transmitted infection enrollment who were medically eligible to initiate Participants attended pre-Eng-Implant (week -2, week 0) inserted end 0 visit returned 12 14. Genital leukocytes (enriched CVL) peripheral mononuclear (PBMC) evaluated markers activation (CD38, HLA-DR), retention (CD103) trafficking (CCR7) (CCR5+CD4+ T cells) multicolor flow cytometry. Cytokines chemokines CVL supernatant plasma measured Luminex assay. estimated compared endpoints among collected before after contraception initiation repeated-measures analyses linear mixed models. Results Fifteen 18 received an completed all visits. The percentage CD4+ was not increased implant placement expressing co-receptor CCR5 did (p = 0.02). In addition, central memory T-cells (CCR7+) 0.004). CD4+, CCR5+ either reduced (HLA-DR+, p 0.01) unchanged (CD38+, 0.45). Most chemokine concentrations significantly different except higher level soluble lymphocyte marker (sCD40L; 0.04) levels IL12p70 0.02) G-CSF (p<0.001). systemic blood, none changes noted occurred decreases CD4 HLA-DR+ 0.006) Conclusions associated moderate availability tract, however these activated minimal shifts overall immune environment. Given nature findings, it unclear if implant-induced alter