title: Biomarkers of Cervical Inflammation and Immunity Associated with Cervical Shedding of HIV-1.
abstract: BACKGROUND
  Cervicovaginal HIV shedding is associated with increased female-to-male and mother-to-child transmission. Genital inflammation may increase shedding through cytokines/chemokines which recruit and activate HIV target cells. We evaluated whether cervical immune mediators present before seroconversion affected HIV shedding and whether mediators differed between shedders and nonshedders.
  
  
  METHODS
  We used cervical samples from 187 African women with documented HIV seroconversion in the Hormonal Contraception and HIV study. Samples were from the two visits before seroconversion (T-2 and/or T-1), and/or at seroconversion (T0), and/or the two visits (T + 1 and/or T + 2) after seroconversion. We measured interleukin (IL)-1β, IL-1 Receptor Antagonist (IL-1RA), IL-6, IL-8, RANTES (Regulated on Activation, Normal T-Cell Expressed and Secreted), MIP-3α, vascular endothelial growth factor (VEGF), Intercellular Adhesion Molecule-1 (ICAM-1), secretory leukocyte protease inhibitor (SLPI), and BD-2 and used the Wilcoxon test and generalized linear models to evaluate the association between mediators and shedding.
  
  
  RESULTS
  The only immune mediator that differed at T-1 was RANTES, which was higher among shedders (p ≤ .05). HIV seroconversion was followed by significant decreases in many mediators, but a significant increase in RANTES. The magnitude of the change was significantly different for shedders versus nonshedders with regard to RANTES (increased in both groups, significantly more so in shedders), SLPI (decreased in both groups, significantly more so in shedders), and MIP-3α (decreased in shedders and increased in nonshedders). At T0, shedders had lower levels of SLPI and MIP-3α than nonshedders.
  
  
  CONCLUSIONS
  In this study, a specific immune mediator profile was associated with risk of cervical HIV shedding. Higher and increasing levels of RANTES and lower and decreasing levels of SLPI and MIP-3α were associated with increased risk of HIV shedding.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Eastern Virginia Medical School , CONRAD, Arlington, Virginia.
authors.forename: Christine
authors.initials: C
authors.lastname: Mauck
authors.affiliation: 2 Department of Biostatistics, FHI 360 , Durham, North Carolina.
authors.forename: Pai-Lien
authors.initials: PL
authors.lastname: Chen
authors.affiliation: 3 Department of Clinical Sciences, FHI 360 , Durham, North Carolina.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Morrison
authors.affiliation: 4 Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts.
authors.forename: Raina N
authors.initials: RN
authors.lastname: Fichorova
authors.affiliation: 2 Department of Biostatistics, FHI 360 , Durham, North Carolina.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kwok
authors.affiliation: 5 Department of Obstetrics and Gynecology, University of Zimbabwe , Harare, Zimbabwe .
authors.forename: Tsungai
authors.initials: T
authors.lastname: Chipato
authors.affiliation: 6 Department of Medicine, Case Western Reserve University , Cleveland, Ohio.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
authors.affiliation: 1 Department of Obstetrics and Gynecology, Eastern Virginia Medical School , CONRAD, Arlington, Virginia.
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Doncel
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D002584:Cervix Uteri / Q000821:virology*; D054418:Chemokine CCL20 / Q000378:metabolism; D018946:Chemokine CCL5 / Q000378:metabolism; D016207:Cytokines / Q000032:analysis*; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000276:immunology; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D053590:Interleukin 1 Receptor Antagonist Protein / Q000378:metabolism; D053583:Interleukin-1beta / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D053481:Secretory Leukocyte Peptidase Inhibitor / Q000378:metabolism; D000069078:Seroconversion; D014621:Vagina / Q000821:virology*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D017201:Virus Shedding / Q000276:immunology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C108355:CCL20 protein, human; C483024:CCL5 protein, human; C508606:CXCL8 protein, human; D054418:Chemokine CCL20; D018946:Chemokine CCL5; D016207:Cytokines; C573420:ICAM1 protein, human; C508585:IL1B protein, human; C507763:IL1RN protein, human; C508600:IL6 protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; C506814:SLPI protein, human; D053481:Secretory Leukocyte Peptidase Inhibitor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1