Effect of Menses on Clearance of Y-Chromosome in Vaginal Fluid: Implications for a Biomarker of Recent Sexual Activity

Brotman, Rebecca M.; Melendez, Johan H.; Smith, Tukisa; Galai, Noya; Zenilman, Jonathan M.

doi:10.1097/olq.0b013e3181b5f15d

Cited by 50 publications

(27 citation statements)

References 14 publications

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“…The sensitivities and concentrations that we report in this study are consistent with other studies, utilizing inoculation or timed intercourse, assessing YcDNA [16,17,26,30]. The half-life of YcDNA is estimated to be 3.6 days [16,17,26] and a previous clinical study reported that YcDNA was absent by 15 days post exposure [17].…”

Section: Discussionsupporting

confidence: 88%

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Assessment of the vaginal residence time of biomarkers of semen exposure

et al. 2016

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Objective The primary objective of this pilot study is to determine and compare the residence time in the vagina of biomarkers of semen exposure for up to 15 days post exposure. The biomarkers are prostate-specific antigen (PSA), Y chromosome DNA, the sex determining region of the Y chromosome (SRY) and testis-specific protein Y-encoded 4 (TSPY4). The secondary objectives are to determine if biomarker concentrations differed between intercourse and inoculation groups, to establish whether the sampling frequency post exposure affected biomarker concentrations and decay profile and to determine if biomarker concentrations in vaginal swabs obtained by the participant at home were similar to swabs obtained by the nurse in the clinic. Study design We randomized healthy women to unprotected intercourse (n=17) versus vaginal inoculation with the male partner’s semen in the clinic (n=16). Women were then further randomized to have vaginal swabs obtained at either 7 or 4 time points after semen exposure, up to 15 days post exposure, either obtained at home by the participant or in the clinic by the research nurse. Results PSA and SRY were markers of recent semen exposure. TSPY4 was detectable in approximately 50% of participants at 15 days post exposure. Unprotected intercourse resulted in significantly higher concentrations of select biomarkers. Sampling frequency and home versus clinic sampling had no significant effect on biomarker concentrations. Conclusions Objective biomarkers of recent or distant semen exposure may have great utility for verifying protocol compliance in a variety of clinical trials.

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Section: Discussionsupporting

confidence: 88%

“…Two genes on the Y chromosome that are of particular interest are the sex determining region of the Y chromosome (SRY) and the testis-specific protein Y-encoded 4 (TSPY4) gene [27–29]. These biomarkers were utilized in small clinical trials, from the cell pellet from cervicovaginal lavage specimens [17] and vaginal swabs [5,17,26,30]. …”

Section: Introductionmentioning

confidence: 99%

Assessment of the vaginal residence time of biomarkers of semen exposure

et al. 2016

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“…Rapid stain identification of human semen (RSID) that detects the presence of semenogelin has also been used in trials to indicate that a woman has been exposed to ejaculate in the previous 48 hours, but is 10-fold less sensitive than quantitative PCR methods to detect Y chromosomal (Yc) DNA (12, 13). Depite heterogeneity in both initial deposit of Yc DNA and rate of decline of Yc DNA signal, Yc has the advantage of detectability up to 15 post-coital days from self-collected vaginal swabs without impact from menses on the rate of decay (14, 15). Yc DNA is not detected in women using condoms correctly as demonstrated by a study that showed that only 5/56 women had positive Yc DNA results after condom use following a 14 day abstinence period and the 5 detections were associated with receptive oral sex and digital penetration (16, 17).…”

Section: Introductionmentioning

confidence: 99%

Y Chromosome and HIV DNA Detection in Vaginal Swabs as Biomarkers of Semen and HIV Exposure in Women

Penrose¹,

Richardson²,

Besson³

et al. 2014

Sexually Transmitted Diseases

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Background The inability to quantify sexual exposure to HIV limits the power of HIV prevention trials of vaccines, microbicides and pre-exposure prophylaxis (PrEP) in women. We investigated detection of HIV-1 and Y chromosomal (Yc) DNA in vaginal swabs from 83 participants in the HPTN 035 microbicide trial as biomarkers of HIV exposure and unprotected sexual activity. Methods 143 vaginal swabs from 85 women were evaluated for the presence of Y chromosomal DNA (Quantifiler Duo DNA quantification kit, Applied Biosystems) and total HIV-1 DNA (single copy in-house qPCR assay). Y DNA detection was paired with self-reported behavioral data with regard to recent coitus (≤ 1 week prior to collection) and condom usage (100% vs. <100% compliance). Results Yc DNA was detected in 62/143 (43%) swabs. For the 126 visits at which both behavioral data and swabs were collected, Yc DNA was significantly more frequent in women reporting <100% condom usage (OR 10.69; 95% confidence interval: 2.27 – 50.32; p=0.003). Notably, 27 of 83 (33%) swabs from women reporting 100% condom usage were positive for Yc DNA. HIV DNA was only detected in swabs collected post-seroconversion. Conclusions The use of Yc DNA in HIV prevention trials could reliably identify sub-groups of women who have unprotected sexual activity and could provide valuable exposure-based estimates of efficacy.

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“…More recently, biomarkers, including the detection of prostate specific antigen (PSA) and Y chromosomal (Yc) DNA in female genital tract samples, have been used as a measure of semen exposure when condomless sex occurred within the past 7 days (9–11). PSA degrades in 24–48 hours (10,12,13) while Yc DNA has been shown to be detectable for at least 7 days (14,15), making Yc DNA testing potentially more sensitive to detecting condomless sex and a proxy measure of recent condomless sex.…”

Section: Introductionmentioning

confidence: 99%

Objective Measurement of Inaccurate Condom Use Reporting Among Women Using Depot Medroxyprogesterone Acetate for Contraception

Heffron

Parikh²,

Penrose

et al. 2016

AIDS Behav

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Observational analyses have suggested that women using the injectable contraceptive depot medroxyprogesterone acetate (DMPA) may have heightened risk of acquiring HIV. However, those analyses were potentially confounded by sexual behavior, with possible differential condom use and reporting by women using DMPA versus no contraception. In a cross-sectional study, we measured the presence of a biomarker of recent condomless sex (Y chromosomal [Yc] DNA) in vaginal swabs from HIV-uninfected African women who had an HIV-infected partner and reported 100% condom use. Half of the samples tested were from women reporting DMPA and half were from women using no contraception. Among 428 specimens tested (213 from DMPA users and 215 from women using no contraception), 32.0% had Yc DNA detected, with a mean of 193 copies/10,000 human cells (range 0.1–8201). The frequency of detection did not differ by contraceptive use: 34.2% of DMPA users versus 29.8% of women using no contraception, adjusted odds ratio 1.3 (95% confidence interval 0.9–2.0). These results suggest that inaccurate reporting of condom use by DMPA users may not account for the heightened risk of HIV acquisition among DMPA users in some observational studies.

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Effect of Menses on Clearance of Y-Chromosome in Vaginal Fluid: Implications for a Biomarker of Recent Sexual Activity

Cited by 50 publications

References 14 publications

Assessment of the vaginal residence time of biomarkers of semen exposure

Assessment of the vaginal residence time of biomarkers of semen exposure

Y Chromosome and HIV DNA Detection in Vaginal Swabs as Biomarkers of Semen and HIV Exposure in Women

Objective Measurement of Inaccurate Condom Use Reporting Among Women Using Depot Medroxyprogesterone Acetate for Contraception

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