Association Between Cervical Inflammation And Cervical Shedding Of Human Immunodeficiency Virus DNA

Kreiss, Joan K.; Willerford, Dennis M.; Hensel, Michelle; Emonyi, Wilfred; Plummer, Francis A.; Ndinya-Achola, Jackoniah O.; Roberts, Pacita L.; Hoskyn, Jerri; Hillier, Sharon L.; Kiviat, Nancy; Holmes, King K.

doi:10.1093/infdis/170.6.1597

Cited by 136 publications

(56 citation statements)

References 15 publications

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“…HIV-1 detection in semen is increased in men with urethritis and gonorrhea (68,243), and treatment of these infections lowers the seminal plasma HIV-1 load (68). Similarly, detection of HIV-1 proviral DNA in the female genital tract is associated with cervical inflammation and increased vaginal discharge (64,166,180). More specifically, Neisseria gonorrhoeae and Chlamydia trachomatis infections enhance the detection of HIV-1 RNA in cervicovaginal secretions, an effect that decreases after successful treatment of the STDs (118).…”

Section: Immune Activation and Biology Of Hiv-1 In Vivo Immune Activamentioning

confidence: 99%

Contribution of Immune Activation to the Pathogenesis and Transmission of Human Immunodeficiency Virus Type 1 Infection

Lawn

Butera²,

Folks³

2001

Clin Microbiol Rev

257

216

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The life cycle of human immunodeficiency virus type 1 (HIV-1) is intricately related to the activation state of the host cells supporting viral replication. Although cellular activation is essential to mount an effective host immune response to invading pathogens, paradoxically the marked systemic immune activation that accompanies HIV-1 infection in vivo may play an important role in sustaining phenomenal rates of HIV-1 replication in infected persons. Moreover, by inducing CD4+ cell loss by apoptosis, immune activation may further be central to the increased rate of CD4+ cell turnover and eventual development of CD4+ lymphocytopenia. In addition to HIV-1-induced immune activation, exogenous immune stimuli such as opportunistic infections may further impact the rate of HIV-1 replication systemically or at localized anatomical sites. Such stimuli may also lead to genotypic and phenotypic changes in the virus pool. Together, these various immunological effects on the biology of HIV-1 may potentially enhance disease progression in HIV-infected persons and may ultimately outweigh the beneficial aspects of antiviral immune responses. This may be particularly important for those living in developing countries, where there is little or no access to antiretroviral drugs and where frequent exposure to pathogenic organisms sustains a chronically heightened state of immune activation. Moreover, immune activation associated with sexually transmitted diseases, chorioamnionitis, and mastitis may have important local effects on HIV-1 replication that may increase the risk of sexual or mother-to-child transmission of HIV-1. The aim of this paper is to provide a broad review of the interrelationship between immune activation and the immunopathogenesis, transmission, progression, and treatment of HIV-1 infection in vivo

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Section: Immune Activation and Biology Of Hiv-1 In Vivo Immune Activamentioning

confidence: 99%

Contribution of Immune Activation to the Pathogenesis and Transmission of Human Immunodeficiency Virus Type 1 Infection

Lawn

Butera²,

Folks³

2001

Clin Microbiol Rev

257

216

View full text Add to dashboard Cite

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“…Unresolved cervicitis can result in ascending infection, endometritis, pelvic inflammatory disease, and salpingitis (11,23,46). Furthermore, cervicitis may enhance human immunodeficiency virus susceptibility by the disruption of mucosa, allowing increased viral replication within recruited inflammatory cells (30). The development of molecular methods, such as PCR and DNA hybridization, has allowed the detection of a range of agents whose etiologic roles in genital infections need to be further investigated, including the viruses cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and HSV-2 (4, 43), adenovirus (6,10,50), and the Mollicutes Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium (1,28,59).…”

mentioning

confidence: 99%

Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma , Ureaplasma , and Trichomonas and Viral Agent Infections in Sexually Active Australian Women

et al. 2009

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Knowing the prevalence of potential etiologic agents of nongonococcal and nonchlamydial cervicitis is important for improving the efficacy of empirical treatments for this commonly encountered condition. We describe four multiplex PCRs (mPCRs), designated VDL05, VDL06, VDL07, and VDL09, which facilitate the detection of a wide range of agents either known to be or putatively associated with cervicitis, including cytomegalovirus (CMV), enterovirus (EV), Epstein-Barr virus (EBV), varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), and herpes simplex virus type 2 (HSV-2) (VDL05); Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, and Mycoplasma hominis ( Cervicitis, an acute or chronic inflammation of the uterine cervix, is generally viewed as a consequence of infection with sexually transmissible agents. Neisseria gonorrhoeae and Chlamydia trachomatis are the most commonly reported pathogens, possibly because they are most frequently screened for. However, the etiology of most cases is undetermined and could be multifactorial in nature (11,34,35,40). Studies undertaken in other epidemiologic settings indicate significant differences in the prevalences of other cervical infectious agents (1,41,44,45,58). An underappreciation of the prevalences of and roles played by these nongonococcal and nonchlamydial agents potentially jeopardizes the effectiveness of empirical treatments for cervicitis. Unresolved cervicitis can result in ascending infection, endometritis, pelvic inflammatory disease, and salpingitis (11,23,46). Furthermore, cervicitis may enhance human immunodeficiency virus susceptibility by the disruption of mucosa, allowing increased viral replication within recruited inflammatory cells (30). The development of molecular methods, such as PCR and DNA hybridization, has allowed the detection of a range of agents whose etiologic roles in genital infections need to be further investigated, including the viruses cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and HSV-2 (4, 43), adenovirus (6,10,50), and the Mollicutes Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium (1,28,59). There have also been reports of genital infections caused by Epstein-Barr virus (EBV) (4, 55), varicella-zoster virus (VZV) (27), and enterovirus (EV) (24). We report here the use of four multiplex PCR (mPCR) assays, designated VDL05, VDL06, VDL07, and VDL09, based on a conventional platform, for the detection of 19 microorganisms in cervical swabs, including Treponema pallidum and C. trachomatis, Trichomonas vaginalis, group B streptococci, and five adenovirus species, in addition to those mentioned above. The assays were developed using cervical swabs from different women taken on one or more occasions during different visits to a sexual-health clinic. MATERIALS AND METHODSPatients. Cervical swabs (n ϭ 233) were taken from 175 women consecutively attending a sexual-health clinic in Sydney, Australia (between one and three visits), during 2006 and 2007 who we...

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“…More highly HIV immunosuppressed individuals are likely to shed more HIV than less highly HIV immunosuppressed individuals and also be more susceptible to STI infection. Studies that have adjusted for the level of HIV immunosuppression, do show higher rates of HIV shedding among males and females with GUD, cervicitis, urethritis, gonorrhoea and chlamydia [46][47][48][49][50].…”

Section: Biological Plausibilitymentioning

confidence: 99%

Curable Sexually Transmitted Infection Treatment Interventions to Prevent HIV Transmission in Sub-Saharan Africa

White¹

2009

TOIDJ

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Abstract:Introduction: Sub-Saharan Africa (Africa) remains the most severely HIV affected region in the world. As there will not be a cure or vaccine against HIV for many years, primary HIV prevention remains key to HIV control. Primary prevention currently includes treatment of curable sexually transmitted infections (STIs). Here, the evidence for curable STI treatment as an HIV prevention strategy in Africa is reviewed.Results: Despite data on the plausible biological mechanisms from laboratory studies and the relative risks from epidemiological studies suggesting that classical STIs do increase the risk of HIV acquisition and transmission, the impact of curable STI treatment on HIV transmission measured in RCTs has varied markedly. Syndromic STI treatment was shown to be an effective strategy in a population with an early HIV epidemic, but neither syndromic STI treatment, nor mass STI treatment were effective in mature HIV epidemics. Among sex workers with relatively low rates of STI, presumptive STI treatment also failed to reduce HIV incidence.Discussion: Rational health policy requires that scarce resources be allocated to interventions with the best costeffectiveness even if relative impact at population level is modest. Curable STI treatment is likely to prevent a decreasing fraction of new HIV infections as the HIV epidemic expands, but, because of increasing HIV incidence it may remain cost-effective for HIV prevention in many African countries.

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Association Between Cervical Inflammation And Cervical Shedding Of Human Immunodeficiency Virus DNA

Cited by 136 publications

References 15 publications

Contribution of Immune Activation to the Pathogenesis and Transmission of Human Immunodeficiency Virus Type 1 Infection

Contribution of Immune Activation to the Pathogenesis and Transmission of Human Immunodeficiency Virus Type 1 Infection

Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma , Ureaplasma , and Trichomonas and Viral Agent Infections in Sexually Active Australian Women

Curable Sexually Transmitted Infection Treatment Interventions to Prevent HIV Transmission in Sub-Saharan Africa

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