Changes in genital tract immune cell populations after initiation of intrauterine contraception

Sharon L. Achilles, Mitchell D Creinin, Kevin A. Stoner, Beatrice A. Chen, Leslie Meyn, Sharon L. Hillier

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


OBJECTIVE: The primary target cells for the human immunodeficiency virus (HIV) infection in the genital tract are CD4 T cells that express CCR5 on the surface. Alterations in genital tract T cells that express CCR5 could impact HIV acquisition risk. We hypothesized that, when compared with baseline, the use of a hormonal intrauterine device (IUD) would alter HIV target cells (primarily CCR5+ CD4 cells) in the female genital tract more than a nonhormonal IUD.

STUDY DESIGN: Thirty-four healthy HIV-negative women aged 18-40 years who were seeking an IUD for contraception were assigned randomly to receive a levonorgestrel IUD or a copper T380A IUD. A parallel group of 8 control women who did not need contraception was also enrolled. Genital tract mucosal immune cell populations that were collected by cervical cytobrush and endometrial biopsy before and 2 months after IUD placement were analyzed by flow cytometry. Mean differences in cell number and percent that expressed receptors from baseline to follow-up examination were evaluated with the use of paired Student t tests.

RESULTS: Neither IUD altered the number of T cells within the upper and lower genital tracts. Levonorgestrel IUD users had a decrease in T cells that expressed the HIV coreceptor CCR5 in the endometrium and cervix after 2 months of use compared with baseline. There was a decrease in activated endometrial T cells in levonorgestrel IUD users and a decrease in activated cervical T cells in copper IUD users after 2 months of IUD use, compared with baseline.

CONCLUSION: Women who use IUDs have reduced expression of the CCR5 HIV coreceptor on T cells in the endometrium and cervix compared with expression before IUD placement. These findings suggest that susceptibility to HIV infection would not be increased by IUD use.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Issue number5
StatePublished - Nov 1 2014
Externally publishedYes


  • CCR5
  • HIV
  • hormonal contraception
  • IUD
  • T cell

ASJC Scopus subject areas

  • Medicine(all)


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