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. 2015 Apr 1;68(4):420-4.
doi: 10.1097/QAI.0000000000000480.

Immunologic, Virologic, and Pharmacologic Characterization of the Female Upper Genital Tract in HIV-infected Women

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Free PMC article

Immunologic, Virologic, and Pharmacologic Characterization of the Female Upper Genital Tract in HIV-infected Women

Lisa Rahangdale et al. J Acquir Immune Defic Syndr. .
Free PMC article

Abstract

: A comparative analysis of cellular and soluble markers of immune activation in HIV-infected women on combination antiretroviral therapy showed that the upper genital tract (UGT) compared to the lower female genital tract was characterized by higher frequencies of potential HIV target cells and increased inflammatory molecules. Despite the activated UGT milieu, HIV RNA could not be detected in paired samples of plasma, cervicovaginal or endometrial lavage. As antiretroviral concentrations were ≥3-fold higher in the endometrium than in the lower genital tract, high antiretroviral penetration and/or metabolism may limit viral replication in the UGT.

Conflict of interest statement

No financial conflicts of interest.

Figures

Figure 1
Figure 1. Immune Activation in the upper and lower female genital tract
Panel A: T cell activation in EML and EMB samples of HIV-positive (closed symbols) and HIV-negative (open symbols) individuals as assessed by CCR5, CD69 and Ki67 expression on CD4+T cells. Panel B: Consistent with HIV-1 infection, the CD4:CD8 T cell ratio is reduced in HIV-positive compared to HIV-negative women in EML samples. Panel C: Levels of sCD14 and sCD163 in CVL and EML samples from HIV-positive and –negative women. The right graph illustrates that despite patient-to-patient variation, in each of the HIV-positive women, inflammatory markers (example of sCD163 shown) were expressed at lower levels in CVL compared to EML samples. Panel D: Several of the inflammatory cytokines in EML were positively correlated to each other suggesting that they all serve as surrogate for immune activation. Examples shown include the correlation between MCP-1 and CXCL-10 and MCP-1 and sCD163. Panel E: IL-1α was the only cytokine that was expressed at significantly higher levels in CVL than in EML samples.

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