Association between cervical shedding of herpes simplex virus and HIV-1.
ABSTRACT To investigate the association between the cervical shedding of herpes simplex virus (HSV) and HIV-1.
A cross-sectional study on 200 women seropositive for both HSV-2 and HIV-1 was conducted in a family planning clinic at the Coast Provincial General Hospital, Mombasa, Kenya.
Quantities of HSV DNA (types 1 and 2) and HIV-1 RNA as well as the presence or absence of HIV-1 proviral DNA in cervical secretions were determined and compared.
There was a significant correlation between the quantities of HSV DNA and HIV-1 RNA in the cervical secretions of HSV-shedding women (Pearson's r = 0.24, P = 0.05). A 10-fold increase in the quantity of cervical HSV DNA was associated with 1.35-fold higher cervical HIV-1-RNA levels (95% CI 1.00-1.81; P = 0.05), and with 1.36-fold greater odds of detection of HIV-1 proviral DNA (95% CI 1.05-1.75; P = 0.02).
Higher levels of cervical HSV were associated with higher levels of expressed HIV-1 and with the more frequent detection of HIV-1-infected cells in cervical secretions. Prospective studies are needed to explore further the association between non-ulcerative cervical HSV reactivation and HIV-1 shedding. Such a relationship may have important implications for interventions designed to slow the spread of HIV-1.
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ABSTRACT: Alcohol abuse is a widespread problem among those at risk for and living with HIV and can impact transmission and disease progression. In this study we sought to use the SIV-macaque model to evaluate the immunological and virological changes in the genital microenvironment of females exposed to chronic alcohol. Female rhesus macaques were treated with alcohol (n=6) or isocaloric sucrose (n=6) for three months and then inoculated with SIVmac251. To assess the effects of chronic alcohol on SIV disease and the genital microenvironment, we quantified plasma and genital SIV levels, measured inflammatory cells in genital fluids, and characterized microbial flora by Gram stains over 10-weeks post-SIV infection. Following three months of alcohol/sucrose treatment, significant differences were observed in the vaginal microenvironment of alcohol treated animals as compared to controls. Microbial flora of alcohol-treated animals had decreased levels of lactobacillus morphotypes and increased levels of gram-positive cocci relative to sucrose-controls. Alcohol-treated animals were also more likely to have white blood cells in vaginal fluids prior to SIV-inoculation, which persisted through viral set-point. Similar levels of cell-free SIV were observed in plasma and vaginal fluids of both groups, but alcohol-treated animals had higher incidence and levels of cell-associated SIV shed in vaginal secretions. Chronic alcohol treatment negatively impacts the genital microenvironment prior to and over the course of SIV infection and may increase the risk of genital virus shedding and transmission.AIDS Research and Human Retroviruses 06/2014; · 2.46 Impact Factor
Article: Strategies for global HIV preventionFuture Virology 11/2006; 1(6):759-767. · 1.00 Impact Factor
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ABSTRACT: Background. HIV-infected (HIV+) men are more susceptible to sexually transmitted infections (STIs), and may also become superinfected by HIV. We hypothesized that HIV induces immune alterations in the foreskin that may impact the subsequent acquisition/clearance of genital co-infections.Methods. Foreskin tissue and blood were obtained from 70 HIV-uninfected and 20 HIV+ men undergoing elective circumcision. Tissue and blood T cells were characterized by flow cytometry, immunohistochemistry, and PCR.Results. There was substantial influx of CD8 T cells into the foreskins of HIV+ men (108.8 vs. 23.1 cells/mm(2), p<0.001); but foreskin CD4 T cell density was unchanged (43.0 vs. 33.7/mm(2), p=0.67), despite substantial blood depletion (409.0 vs. 877.8 cells/mm(3), p<0.001). While frequencies of foreskin CCR5+ T cells, Tregs and Th17 cells were unaltered in HIV+ men; CD8 T cell production of TNFα was decreased. HIV-specific CD8 T cells were present in the foreskins of HIV+ men, although their frequency and function was reduced compared to the blood.Conclusions. Foreskin CD4 T cell density and CCR5 expression were not reduced during HIV infection, perhaps explaining susceptibility to HIV superinfection. Foreskin CD8 T cell density was increased, but decreased production of TNFα may enhance susceptibility to foreskin-acquired genital co-infections in HIV+ men.The Journal of Infectious Diseases 11/2013; · 5.85 Impact Factor