[21] DETECTION OF HIV, CHLAMYDIA, GONORRHEA, AND HERPES SIMPLEX BY DNA PCR IN CERVICOVAGINAL FLUIDS: CORRELATES OF MALE TO FEMALE AND FEMALE TO MALE TRANSMISSION OF HIV-1 INFECTION IN ZAMBIA

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] DETECTION OF HIV, CHLAMYDIA, GONORRHEA, AND HERPES SIMPLEX BY DNA PCR IN CERVICOVAGINAL FLUIDS: CORRELATES OF MALE TO FEMALE AND FEMALE TO MALE TRANSMISSION OF HIV-1 INFECTION IN ZAMBIA

[AUTHOR(S):] R Chavuma¹ for the the Rwanda/Zambia HIV Research Group^2,5
¹University Teaching Hospital, Lusaka, Zambia; ²Project San Francisco, Kigali, Rwanda; ³University of Alabama in Birmingham (UAB), AL, USA; ⁴Zambia-UAB HIV Research project (ZUHRP), Lusaka, Zambia; and ⁵University of Washington, Seattle, USA

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 21
Antiviral Therapy 2003; 8(Suppl. 1):S190

[ABSTRACT:] Objective: To assess HIV shedding and detection of STDs in cervicovaginal fluids (CVF) in relation to female-to-male and male-to-female transmission of HIV.

Methods: We examined 46 women who transmitted HIV to their partners, a comparison group of 40 HIV+ non-transmitters, and 57 seroconvertors enrolled in a study of HIV discordant couples in Lusaka, Zambia. HIV DNA PCR was performed on CVF swab samples taken 3 months prior to seroconversion, at the time of detectable antibodies, and 3 months after, or at 3 consecutive visits in non-transmitters. CVF was screened for Chlamydia trachomatis, Neisseria gonorrhea and Herpes Simplex Virus (HSV) by PCR. 54 HIV negative non-convertors were also screened for these STD.

Results: HIV DNA was detected in 56% (49/88) CVF samples from seroconvertors, 72% (71/99) from transmitters, and 56/89 (63%) of non-transmitters (P=ns). 11/47 (23%) of CVF samples from the pre-conversion swabs were also PCR positive for HIV. The prevalence of gonorrhea (4/60 samples vs 2/60) and chlamydia (0/122) was not different in transmitters and non-transmitters. Seroconvertors had slightly more chlamydia than non-convertors (8/85 vs 2/91 positive samples, involving 6 seroconvertors and 1 non-convertor). Seroconvertors also had more gonorrhea than non-convertors (7/78 samples vs 1/91). HSV shedding was highest in transmitters at the visit prior to their partners’ seroconversion (6/31 samples) and in seroconvertors at the time of the first positive HIV antibody test (5/39 samples); only 3/194 remaining samples were HSV positive. 16/47 seroconvertors had ≥1 of these pathogens, compared with 5/48 non-convertors.

Conclusions: HIV is detectable in most CVF samples from HIV+ and some seroconverting women. Most HIV transmissions occurred without chlamydia, gonorrhea, or HSV. Male-to-female transmission was associated with chlamydia and gonorrhea, but female-to-male transmission was not. HSV shedding in CVF was associated with both acquiring and transmitting HIV.

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