The associations between cervicovaginal HIV shedding, sexually transmitted diseases and immunosuppression in female sex workers in Abidjan, Côte dʼIvoire

Ghys, Peter D.; Fransen, Katrien; Diallo, Mamadou O.; Ettiègne-Traoré, Virginie; Coulibaly, Issa; Yeboue, Kouadio; Kalish, Marcia L.; Maurice, Chantal; Whitaker, J. P.; Greenberg, Alan E.; Laga, Marie

doi:10.1097/00002030-199712000-00001

Cited by 315 publications

(207 citation statements)

References 33 publications

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“…2,6e8 It is thought that the long war that ravaged the country from 1963 to 1974 increasing the risk of sexual abuse and promiscuity, parenteral transmission through female ritual excision and multiple injections for the treatment of tuberculosis and the prevention of trypanosomiasis significantly contributed to its spread, 1,2,9 but its prevalence is now declining 10e12 The reasons for this decline are not clear as various data converge to show that survival is longer in patients infected with HIV-2 than in those infected with HIV-1, and that a larger percentage of HIV-2 infected individuals become long-term non-progressors 13,14 and therefore potentially contribute to the spread of the infection for a long time. On the other hand, the modest genital shedding of HIV-2 15e17 probably reduces the efficiency of sexual transmission, as suggested by the considerably slower spread of HIV-2 among sex workers 16,18 and the marked reduction in HIV-2 in Angola and Mozambique at the end of 1990s. 1 HIV-1 in Guinea-Bissau is mainly represented by the A/G (CRF 02_AG) recombinant strain, 19,20 and the finding of clusters, which contained sequences separated by short branches, suggests that the virus had time to evolve in the country.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk determinants of HIV-1 and HIV-2 infections in pregnant women in Bissau

Gianelli

Riva

Bravo

et al. 2010

Journal of Infection

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Summary Objectives: To analyse the risk determinants of HIV-1 and HIV-2 infections in pregnant women in Bissau. Methods: Pregnant women attending the antenatal clinics of Bissau between January 2002 and June 2006 were consecutively tested unless they opted out. Results: Among 23,869 tested women the overall prevalence of HIV-1 was 5.7%, that of HIV-2 was 2.4%, and these included the 0.7% prevalence of HIV-1 and HIV-2 duals. The main factors associated with the risk of HIV-1 infection were older age, occupation and number of sexual partners. Beafada and Mandinga ethnic groups were at greater risk of presenting HIV-1, and Bijago and Papel at lower risk. The factors associated with the risk of HIV-2 were age, literacy and occupation; the Beafada were at greater risk than the other ethnic groups. Conclusions: The prevalence of HIV-2 infection decreased overtime, whereas that of HIV-1 infection remained substantially stable, but was higher than that observed in previous studies. The rapid decline in the rates of HIV-2 infection suggests that many of the factors that allowed its exponential growth in the past have now been partially removed, and that sexual and vertical transmission have not been sufficient to maintain and extend the epidemic.

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Section: Introductionmentioning

confidence: 99%

Prevalence and risk determinants of HIV-1 and HIV-2 infections in pregnant women in Bissau

Gianelli

Riva

Bravo

et al. 2010

Journal of Infection

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“…Women with laboratory-diagnosed Ng infections are at a significantly higher risk of HIV-1 acquisition, even when the data have been controlled for demographic and behavioral factors, clinical symptoms, and other STIs (9). Symptomatic Ng infection is associated with increased detection of viral-derived nucleic acids from genital secretions of men and women (11)(12)(13), and this effect was reversed upon successful Ng treatment. Concurrent Ng infection is associated with an increase in HIV-1 viremia (14,15), decreases in HIV-1 target lymphocyte [cluster of differentiation 4-positive (CD4 + ) T-cell] counts (14), and a decrease in effector [cluster of differentiation 8-positive (CD8 + ) T-cell] lymphocyte responses (16).…”

mentioning

confidence: 99%

Neisseria gonorrhoeae-derived heptose elicits an innate immune response and drives HIV-1 expression

Malott¹,

Keller

Gaudet³

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

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Clinical and epidemiological synergy exists between the globally important sexually transmitted infections, gonorrhea and HIV. Neisseria gonorrhoeae , which causes gonorrhea, is particularly adept at driving HIV-1 expression, but the molecular determinants of this relationship remain undefined. N. gonorrhoeae liberates a soluble factor that potently induces expression from the HIV-1 LTR in coinfected cluster of differentiation 4-positive (CD4 + ) T lymphocytes, but this factor is not a previously described innate effector. A genome-wide mutagenesis approach was undertaken to reveal which component(s) of N. gonorrhoeae induce HIV-1 expression in CD4 + T lymphocytes. A mutation in the ADP-heptose biosynthesis gene, hldA , rendered the bacteria unable to induce HIV-1 expression. The hldA mutant has a truncated lipooligosaccharide structure, contains lipid A in its outer membrane, and remains bioactive in a TLR4 reporter-based assay but did not induce HIV-1 expression. Mass spectrometry analysis of extensively fractionated N. gonorrhoeae- derived supernatants revealed that the LTR-inducing fraction contained a compound having a mass consistent with heptose-monophosphate (HMP). Heptose is a carbohydrate common in microbes but is absent from the mammalian glycome. Although ADP-heptose biosynthesis is common among Gram-negative bacteria, and heptose is a core component of most lipopolysaccharides, N. gonorrhoeae is peculiar in that it effectively liberates HMP during growth. This N. gonorrhoeae- derived HMP activates CD4 + T cells to invoke an NF-κB–dependent transcriptional response that drives HIV-1 expression and viral production. Our study thereby shows that heptose is a microbial-specific product that is sensed as an innate immune agonist and unveils the molecular link between N. gonorrhoeae and HIV-1.

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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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The associations between cervicovaginal HIV shedding, sexually transmitted diseases and immunosuppression in female sex workers in Abidjan, Côte dʼIvoire

Cited by 315 publications

References 33 publications

Prevalence and risk determinants of HIV-1 and HIV-2 infections in pregnant women in Bissau

Prevalence and risk determinants of HIV-1 and HIV-2 infections in pregnant women in Bissau

Neisseria gonorrhoeae-derived heptose elicits an innate immune response and drives HIV-1 expression

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

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