Hormonal contraception and hiv-1 infection: Medroxyprogesterone acetate suppresses innate and adaptive immune mechanisms

Academic Article


  • Recent observational studies indicate an association between the use of hormonal contraceptives and acquisition and transmission of HIV-1. The biological and immunological mechanisms underlying the observed association are unknown. Depot medroxyprogesterone acetate (DMPA) is a progestin-only injectable contraceptive that is commonly used in regions with high HIV-1 prevalence. Here we show that medroxyprogesterone acetate (MPA) suppresses the production of key regulators of cellular and humoral immunity involved in orchestrating the immune response to invading pathogens.MPAinhibited the production of interferon (IFN)-α, IL-2, IL-4, IL-6, IL-12, TNFα, macrophageinflammatory protein-1α (MIP-1α),andother cytokinesandchemokines by peripheral blood cells and activated T cells and reduced the production of TNFα and TNFα by plasmacytoid dendritic cells in response to Toll-like receptor-7, -8, and -9 ligands. Women using DMPA displayed lower levels of TNFα in plasma and genital secretions compared with controls with no hormonal contraception. In addition, MPA prevented the down-regulation of HIV-1 coreceptors CXCR4 and CCR5 on the surface of T cells after activation and increased HIV-1 replication in activated peripheral blood mononuclear cell cultures. The presented results suggest that MPA suppresses both innate and adaptive arms of the immune system resulting in a reduction of host resistance to invading pathogens. Copyright © 2013 by The Endocrine Society.
  • Published In

  • Endocrinology  Journal
  • Digital Object Identifier (doi)

    Author List

  • Huijbregts RPH; Helton ES; Michel KG; Sabbaj S; Richter HE; Goepfert PA; Hel Z
  • Start Page

  • 1282
  • End Page

  • 1295
  • Volume

  • 154
  • Issue

  • 3