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.
Wright
T C
TC
Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA. tcw1@columbia.edu
Subbarao
S
S
Ellerbrock
T V
TV
Lennox
J L
JL
Evans-Strickfaden
T
T
Smith
D G
DG
Hart
C E
CE
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