Cell-associated, non-replicating strand(+) hepatitis C virus-RNA shedding in cervicovaginal secretions from chronically HCV-infected women.
BACKGROUND
Lack of mucosal hepatitis C virus (HCV) transmission may be due to fairly low infectivity of body fluids in HCV-infected individuals in association with yet unknown innate or acquired resistance factors in individuals exposed to the virus.


OBJECTIVE
To evaluate HCV excretion patterns in cervicovaginal secretions obtained from chronically HCV-infected women.


METHODS
Fifteen chronically HCV-infected women of childbearing age hospitalized for chronic hepatitis were prospectively recruited. Cervicovaginal secretions were obtained by vaginal washing with 3 ml phosphate-buffered saline (PBS). All cervicovaginal secretions were free of hemoglobin traces and also free of semen traces. Free HCV-RNA and cell-associated HCV-RNA were examined in acellular part and cellular part of the cervicovaginal secretions, respectively, by in-house qualitative PCR for 5'-HCV-non-coding region (NCR). Negative strand HCV-RNA, a marker of HCV replication, was searched by using tag-RT-nested PCR (tag-RT-NPCR).


RESULTS
HCV-RNA could not be detected in the acellular fractions of the 15 evaluated cervicovaginal secretions. In contrast, HCV-RNA could be detected in the cellular fractions of four of 15 (27%) cervicovaginal secretions. None of the cervicovaginal secretions, including the four positive cell-associated HCV-RNA, contained negative strand, replicating HCV-RNA.


CONCLUSIONS
Our results suggest that positive strand HCV-RNA may be present outside the menstruation periods as cell-associated virus in the cervicovaginal secretions of a minority of untreated HCV-seropositive, HCV-RNA-viremic women, and that the lower female genital tract does not constitute a reservoir where HCV replicates. These observations thus provide the basis for the low risk of female-to-male sexual transmission of HCV infection.
Bélec
Laurent
L
Unité INSERM U430 (Immunopathologie Humaine), Hôpital Broussais, Université Pierre and Marie Curie (Paris VI), Paris, France. laurent.belec@egp.ap-hop-paris.fr
Legoff
Jérôme
J
Si-Mohamed
Ali
A
Bloch
Francis
F
Matta
Mathieu
M
Mbopi-Keou
François-Xavier
FX
Payan
Christopher
C
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000166:cytology / Q000378:metabolism / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000821:virology*; D006801:Humans; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis*; D014621:Vagina / Q000166:cytology / Q000378:metabolism / Q000821:virology*; D014779:Virus Replication; D017201:Virus Shedding
D012367:RNA, Viral