Systemic Immune Activation and HIV Shedding in the Female Genital Tract

Journal of Acquired Immune Deficiency Syndromes : JAIDS
L Y SpencerA Kovacs

Abstract

Plasma HIV RNA is the most significant determinant of cervical HIV shedding. However, shedding is also associated with sexually transmitted infections (STIs) and cervical inflammation. The mechanism by which this occurs is poorly understood. There is evidence that systemic immune activation promotes viral entry, replication, and HIV disease progression. We hypothesized that systemic immune activation would be associated with an increase in HIV genital shedding. Clinical assessments, HIV RNA in plasma and genital secretions, and markers of immune activation (CD38(+)DR(+) and CD38(-)DR(-)) on CD4(+) and CD8(+) T cells in blood were evaluated in 226 HIV+ women enrolled in the Women's Interagency HIV Study. There were 569 genital evaluations of which 159 (28%) exhibited HIV RNA shedding, defined as HIV viral load >80 copies per milliliter. We tested associations between immune activation and shedding using generalized estimating equations with logit link function. In the univariate model, higher levels of CD4(+) and CD8(+) T-cell activation in blood were significantly associated with genital tract shedding. However, in the multivariate model adjusting for plasma HIV RNA, STIs, and genital tract infections, only higher levels of res...Continue Reading

References

Dec 1, 1996·Microbiological Reviews·K F Copeland, J L Heeney
Feb 1, 1997·Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association·J M BenitoE Fernández-Cruz
Jul 1, 1997·Journal of Leukocyte Biology·S M Wahl, J M Orenstein
Mar 21, 1998·Epidemiology·S E BarkanJ Feldman
Jun 8, 2000·Journal of Acquired Immune Deficiency Syndromes : JAIDS·A KovacsA M Levine
Apr 18, 2001·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M DebiaggiG Filice
Nov 22, 2001·Lancet·A KovacsUNKNOWN WIHS Study Group
Dec 18, 2003·International Journal of STD & AIDS·G U Natividad-VillanuevaS Cu-Uvin
Nov 23, 2006·Nature Medicine·Jason M BrenchleyDaniel C Douek
Mar 7, 2007·Current HIV/AIDS Reports·Satya Dandekar
Dec 29, 2007·The Journal of Pathology·V Appay, D Sauce
May 1, 2008·The Journal of Infectious Diseases·Andrea KovacsAlan Landay
Dec 17, 2008·Mucosal Immunology·J M Brenchley, D C Douek
Sep 24, 2011·The Journal of Infectious Diseases·Heather B JaspanJo-Ann Passmore
Apr 21, 2012·Journal of Acquired Immune Deficiency Syndromes : JAIDS·James HomansAndrea Kovacs
Nov 19, 2013·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Priyanka KhopkarSmita Kulkarni

❮ Previous
Next ❯

Citations

Dec 15, 2017·The Journal of Infectious Diseases·Caroline C KingUNKNOWN Partners in Prevention HSV/HIV Transmission Study and Partners PrEP Study Teams

❮ Previous
Next ❯

Related Concepts