Epidemiologic and biologic characterization of a cohort of human immunodeficiency virus type 1 highly exposed, persistently seronegative female sex workers in northern Thailand. Chiang Mai HEPS Working Group.
Characterization of persons highly exposed to human immunodeficiency virus (HIV)-1 who remain uninfected may help define protective immunity. Seventeen HIV-1-seronegative Thai female sex workers (CSWs) with epidemiologic evidence of exposure to HIV-1 were studied for humoral immune responses and phenotypic and genotypic analyses of HLA class I and CCR5 allelic profiles. Infected CSWs and low-risk HIV-1-seronegative Thai women were controls. Highly exposed, persistently seronegative (HEPS) CSWs did not differ from HIV-infected CSWs in HIV risks, condom use, or sexually transmitted diseases. Significant differences were seen in humoral immune responses: gp160-specific IgA responses were detected in cervicovaginal lavage fluids in 6 of 13 HEPS CSWs but 0 of 21 seronegative subjects. All women had wild-type CCR5. HEPS CSWs were more likely to have the HLA-B18 phenotype and genotype than were matched controls (corrected P=.018). Epidemiologic exposure to HIV-1 without apparent infection, an unusual distribution of HLA class I alleles, and HIV-1 gp160-specific IgA responses suggest a biologic basis for this phenomenon.
Beyrer
C
C
Division of Retrovirology, Walter Reed Army Institute of Research, Bethesda, MD, USA. cbeyrer@jhsph.edu
Artenstein
A W
AW
Rugpao
S
S
Stephens
H
H
VanCott
T C
TC
Robb
M L
ML
Rinkaew
M
M
Birx
D L
DL
Khamboonruang
C
C
Zimmerman
P A
PA
Nelson
K E
KE
Natpratan
C
C
D000293:Adolescent; D000328:Adult; D001826:Body Fluids / Q000276:immunology; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D005805:Genes, MHC Class I; D015483:HIV Antibodies / Q000378:metabolism; D019302:HIV Envelope Protein gp160 / Q000276:immunology; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000635:transmission*; D018023:HIV Seronegativity / Q000276:immunology; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D018928:Immunity, Mucosal; D007071:Immunoglobulin A, Secretory / Q000378:metabolism; D016036:Seroepidemiologic Studies; D011477:Sex Work; D013785:Thailand / Q000453:epidemiology; D014621:Vagina / Q000276:immunology
D015483:HIV Antibodies; D019302:HIV Envelope Protein gp160; D007071:Immunoglobulin A, Secretory