title: Genital tract human immunodeficiency virus type 1 (HIV-1) shedding and inflammation and HIV-1 env diversity in perinatal HIV-1 transmission.
abstract: This study sought to identify genital tract characteristics associated with vertical transmission of human immunodeficiency virus type 1 (HIV-1). HIV-1 DNA and RNA, HIV-1 env diversity, and inflammatory cells were quantified in cervicovaginal lavages (CVLs) of 24 women enrolled in the Women and Infants Transmission Study; 7 women transmitted HIV-1 perinatally. Vaginal candidiasis, HIV-1 culture positivity, levels of HIV-1 DNA and cell-free RNA, and HIV-1 env diversity were significantly higher in the CVLs of transmitters. CVL HIV-1 DNA levels correlated with higher levels of inflammatory cells and cell-free HIV-1 RNA. Of subjects with paired blood and CVL specimens, there was more HIV-1 env heterogeneity between blood and CVLs in transmitters than in nontransmitters. In summary, increased HIV-1 shedding is correlated with a more complex population of HIV-1 quasispecies in the genital tracts of parturient women, which may increase the probability that a fetotropic strain is transmitted.
authors.affiliation: Department of Obstetrics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Panther
authors.forename: L
authors.initials: L
authors.lastname: Tucker
authors.forename: C
authors.initials: C
authors.lastname: Xu
authors.forename: R E
authors.initials: RE
authors.lastname: Tuomala
authors.forename: J I
authors.initials: JI
authors.lastname: Mullins
authors.forename: D J
authors.initials: DJ
authors.lastname: Anderson
mesh_terms: D002584:Cervix Uteri / Q000276:immunology / Q000821:virology; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015686:Gene Products, env / Q000235:genetics*; D014644:Genetic Variation; D005836:Genitalia, Female / Q000821:virology; D015658:HIV Infections / Q000276:immunology / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000235:genetics* / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D009504:Neutrophils / Q000276:immunology; D009692:Nucleic Acid Heteroduplexes / Q000032:analysis; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D011533:Proviruses; D012367:RNA, Viral / Q000032:analysis; D014621:Vagina / Q000276:immunology / Q000821:virology; D019562:Viral Load; D017201:Virus Shedding
chemical_list: D004279:DNA, Viral; D015686:Gene Products, env; D009692:Nucleic Acid Heteroduplexes; D012367:RNA, Viral