HIV-inducing factor in cervicovaginal secretions is associated with bacterial vaginosis in HIV-1-infected women.
OBJECTIVE
Certain cervicovaginal lavage (CVL) fluid samples obtained from HIV-1-infected and uninfected women stimulate in vitro HIV-1 replication. This activity, HIV-inducing factor (HIF), changes when CVL fluid is heated. We sought to confirm a previous observation that HIF was associated with bacterial vaginosis (BV).


METHODS
HIF was measured in unheated and heated CVL fluid obtained from HIV-1-infected women and compared with the presence of BV by Nugent scores, other genital tract conditions, and cervicovaginal HIV-1 shedding.


RESULTS
Among the 295 women studied, 54% of CVL samples had HIF activity and 21% showed heat-stable HIF activity. In adjusted logistic regression, heat-stable HIF was associated with BV (odds ratio [OR]=51.7, 95% confidence interval [CI]: 5.0, 530.7) and with intermediate flora (OR=43.3, 95% CI: 3.6, 521.1); heat-labile HIF was not associated with BV. Neither heat-stable nor heat-labile HIF was associated with other cervicovaginal conditions nor, after controlling for plasma viral load, with genital tract HIV-1 shedding.


CONCLUSIONS
We confirmed the association of HIF with BV and attribute it to the heat-stable component. Heat-stable activity is also associated, although less strongly, with intermediate vaginal flora. We propose that heat-stable HIF is a result of products of BV-associated bacteria.
Division of Infectious Diseases, Department of Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA. jcohn@med.wayne.edu
Jonathan A
JA
Cohn
Farhad B
FB
Hashemi
Margaret
M
Camarca
Fanhui
F
Kong
Jiahong
J
Xu
Suzanne K
SK
Beckner
Andrea A
AA
Kovacs
Patricia S
PS
Reichelderfer
Gregory T
GT
Spear
D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006358:Hot Temperature; D006801:Humans; D066298:In Vitro Techniques; D014621:Vagina / Q000378:metabolism / Q000821:virology; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000503:physiopathology; D014779:Virus Replication