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Genital Tract Inflammation During Early HIV-1 Infection Predicts Higher Plasma Viral Load Set Point in Women

Lindi Roberts; Jo-Ann S. Passmore; Koleka P. Mlisana; Carolyn Williamson; Francesca Little; Lisa M. Bebell; Gerhard Walzl; Melissa-Rose Abrahams; Zenda Woodman; Quarraisha Abdool Karim; Salim Abdool Karim

Title:
Genital Tract Inflammation During Early HIV-1 Infection Predicts Higher Plasma Viral Load Set Point in Women
Author(s):
Roberts, Lindi
Passmore, Jo-Ann S.
Mlisana, Koleka P.
Williamson, Carolyn
Little, Francesca
Bebell, Lisa M.
Walzl, Gerhard
Abrahams, Melissa-Rose
Woodman, Zenda
Abdool Karim, Quarraisha
Abdool Karim, Salim
Date:
Type:
Articles
Department:
Epidemiology
Volume:
205
Permanent URL:
Book/Journal Title:
Journal of Infectious Diseases
Abstract:
Background. The biggest challenge in human immunodeficiency virus type 1 (HIV-1) prevention in Africa is the high HIV-1 burden in young women. In macaques, proinflammatory cytokine production in the genital tract is necessary for target cell recruitment and establishment of simian immunodeficiency virus (SIV) infection following vaginal inoculation. The purpose of this study was to assess if genital inflammation during early HIV-1 infection predisposes women to rapid disease progression. Methods. Inflammatory cytokine concentrations were measured in cervicovaginal lavage (CVL) from 49 women 6, 17, 30, and 55 weeks after HIV-1 infection and from 22 of these women before infection. Associations between genital inflammation and viral load set point and blood CD4 cell counts 12 months after infection were investigated. Results. Elevated genital cytokine concentrations 6 and 17 weeks after HIV-1 infection were associated with higher viral load set points and, to a lesser extent, with CD4 depletion. CVL cytokine concentrations during early infection did not differ relative to preinfection but were elevated in women who had vaginal discharge, detectable HIV-1 RNA in their genital tracts, and lower blood CD4 counts. Conclusion. Genital inflammation during early HIV-1 infection was associated with higher viral load set point and CD4 depletion, which are markers of rapid disease progression. Strategies aimed at reducing genital inflammation during early HIV-1 infection may slow disease progression.
Subject(s):
Virology
Epidemiology
Publisher DOI:
http://dx.doi.org/10.1093/infdis/jir715
Item views:
309
Metadata:
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