Genital tract human immunodeficiency virus type 1 (HIV-1) shedding and inflammation and HIV-1 env diversity in perinatal HIV-1 transmission

J Infect Dis. 2000 Feb;181(2):555-63. doi: 10.1086/315230.


This study sought to identify genital tract characteristics associated with vertical transmission of human immunodeficiency virus type 1 (HIV-1). HIV-1 DNA and RNA, HIV-1 env diversity, and inflammatory cells were quantified in cervicovaginal lavages (CVLs) of 24 women enrolled in the Women and Infants Transmission Study; 7 women transmitted HIV-1 perinatally. Vaginal candidiasis, HIV-1 culture positivity, levels of HIV-1 DNA and cell-free RNA, and HIV-1 env diversity were significantly higher in the CVLs of transmitters. CVL HIV-1 DNA levels correlated with higher levels of inflammatory cells and cell-free HIV-1 RNA. Of subjects with paired blood and CVL specimens, there was more HIV-1 env heterogeneity between blood and CVLs in transmitters than in nontransmitters. In summary, increased HIV-1 shedding is correlated with a more complex population of HIV-1 quasispecies in the genital tracts of parturient women, which may increase the probability that a fetotropic strain is transmitted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cervix Uteri / immunology
  • Cervix Uteri / virology
  • Cohort Studies
  • DNA, Viral / analysis
  • Female
  • Gene Products, env / genetics*
  • Genetic Variation*
  • Genitalia, Female / virology
  • HIV Infections / immunology
  • HIV Infections / transmission*
  • HIV Infections / virology
  • HIV-1 / genetics*
  • HIV-1 / physiology
  • Humans
  • Infant
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Neutrophils / immunology
  • Nucleic Acid Heteroduplexes / analysis
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Proviruses
  • RNA, Viral / analysis
  • Vagina / immunology
  • Vagina / virology
  • Viral Load
  • Virus Shedding


  • DNA, Viral
  • Gene Products, env
  • Nucleic Acid Heteroduplexes
  • RNA, Viral