F6/1 - FACTORS ASSOCIATED WITH HIV-1 SHEDDING IN THE GENITAL TRACT OF WOMEN WITH UNDETECTABLE PLASMA HIV-1 VIRAL LOAD. POTENTIAL SOURCES OF CELL-FREE HIV-1 IN VAGINAL SECRETIONS

9^TH EUROPEAN AIDS CONFERENCE (EACS)
1^st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

October 25 - 29, 2003 Warsaw, Poland

6.10 Compartments of Viral Spreading

F6/1 - FACTORS ASSOCIATED WITH HIV-1 SHEDDING IN THE GENITAL TRACT OF WOMEN WITH UNDETECTABLE PLASMA HIV-1 VIRAL LOAD. POTENTIAL SOURCES OF CELL-FREE HIV-1 IN VAGINAL SECRETIONS

* Gimeno A.¹, Portilla J.², Boix V.², Plazas J.¹, Sánchez-Payá J.³, Ochando M.¹, Llopis C.¹, Merino E.², Arroyo E.¹, Pardo M.A.¹, Reus S.², Sánchez R.²

(1) Unit of Clinical Microbiology,² Unit of Infectious Diseases,³ Unit of Epidemiology, Hospital General Universitario de Alicante, Alicante, Spain

Background of Study: HIV can be detected in the genital tract of some women with undetectable plasma HIV. HCV is present in genital secretions only through plasma transudation.

Objectives: To study factors associated with vaginal HIV-1 shedding in aviremic women and plasma viral transudation as a potential source of vaginal HIV RNA.

Methods: 154 paired blood/vaginal samples were collected, genital secretions were directly aspirated. HIV pooled DNA+RNA, RNA and HCV RNA levels were determined by RT-PCR. Blood or semen contaminated vaginal samples were discarded. Univariate and multivariate analyses were performed. Plasma/vagina and HCV/HIV ratios were compared.

Results: Plasma HIV was undetectable in 64 samples; HIV DNA+RNA was detected in 17% and RNA in 11% of vaginal samples. Time on antiretroviral therapy, CD4 and vaginal polymorphonuclear leukocytes counts(VPMNs) were associated with genital HIV DNA+RNA. Pregnancy and VPMNs were associated with vaginal HIV RNA. In multivariate analysis VPMNs was the only variable associated with HIV genital shedding. HIV RNA was detected in 58% of plasma and 28% of vaginal samples. Of 68 samples from women HCV coinfected, HCV was detected in 77% of plasma and 6% of vaginal samples. Plasma HCV/HIV ratio was 1.4, plasma/vagina HIV and HCV ratios were 1.1 and 1.7.

Conclusions: VPMNs is associated with HIV genital shedding in aviremic women. Although plasma HCV viral load was equal to or greater than HIV, vaginal HCV is rarely detected. This difference suggests that transudation is not a major source of HIV in vaginal secretions.

Presenting Author: Dr Adelina Gimeno, S. Microbiologia. Hospital General Universitario de Alicante, Maestro Alonso 109, 03010, Alicante, Spain, Phone: 34965938519

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