Human immunodeficiency virus 1 expression in the female genital tract in association with cervical inflammation and ulceration.
OBJECTIVE
Determining the source of human immunodeficiency virus 1 in the female genital tract and identifying factors that influence the amount of virus shed are important in the understanding of heterosexual human immunodeficiency virus 1 transmission.


METHODS
Cervicovaginal human immunodeficiency virus 1 ribonucleic acid shedding was quantified before and after treatment of cervical squamous intraepithelial lesions in 14 women. Genotypic analysis was performed on peptide HIV-1 env gp120 of the major human immunodeficiency virus 1 species in plasma and cervicovaginal lavage of selected samples.


RESULTS
At 2 to 4 weeks after treatment, when cervices were inflamed and ulcerated, human immunodeficiency virus 1 ribonucleic acid in lavage samples increased 1.0 to 4.4 log 10. Genotypic analysis showed significant differences between the predominant human immunodeficiency virus 1 species in paired plasma and lavage samples from 2 of 4 women, suggesting that the increase in human immunodeficiency virus 1 was the result of local viral replication.


CONCLUSIONS
Cervical inflammation and ulceration are associated with local human immunodeficiency virus 1 expression, which increases as much as 10,000-fold the amount of human immunodeficiency virus 1 shed into genital secretions. This may explain why sexually transmitted diseases are important risk factors for human immunodeficiency virus transmission.
Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA. tcw1@columbia.edu
T C
TC
Wright
S
S
Subbarao
T V
TV
Ellerbrock
J L
JL
Lennox
T
T
Evans-Strickfaden
D G
DG
Smith
C E
CE
Hart
D000328:Adult; D005260:Female; D015967:Gene Expression Regulation, Viral; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000635:transmission; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000821:virology*; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood / Q000737:chemistry / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D007507:Therapeutic Irrigation; D014456:Ulcer / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*; D002575:Uterine Cervicitis / Q000821:virology*; D019562:Viral Load; D014779:Virus Replication; D017201:Virus Shedding; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery / Q000821:virology*
D012367:RNA, Viral