AEGiS-11IAC: Characterization of antibody, cytokine and complement levels in cervicovaginal (CVL) fluid in HIV-infected and uninfected women.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Characterization of antibody, cytokine and complement levels in cervicovaginal (CVL) fluid in HIV-infected and uninfected women.

Int Conf AIDS 1996 Jul 7-12; 11:5 (abstract no. Mo.A.142)
D'Amico RD, Sha BE, Landay AL, Spear GT, Massad LS, Padnick J, Payne G, Charles LA, Benson CA; Section of Infectious Disease, Rush Medical College, Chicago IL.

OBJECTIVE: To characterize antibody, cytokine, and complement levels in CVL fluid and to determine associations with HIV status, concurrent genital infection, and/or cervical dysplasia or HPV.

METHODS: Twenty-one women participating in the Women's Interagency HIV Study underwent CVL collection using 10 cc of sterile NaCL. Gynecologic exam included detection of genital infection and dysplasia or HPV. Patients were subdivided into 4 groups: high-risk HIV-negative (5), HIV+/CD4 greater than 500 (5), HIV+/CD4 200-500 (6), HIV+/CD4 less than 200 (5). CVL fluid was assayed for levels of IgG, sIgA, IL-2, IL-10, TNF-alpha, IL-1beta, IFN-gamma, IL-6, C3, C1q, and CH50 for C4. Immunoglobulin, cytokine, C3 and C1q were measured by ELISA; C4 levels were measured by red cell lysis. Comparative univariate and multivariate analyses were performed.

RESULTS: There was no significant difference in the incidence of vaginal infection between HIV-infected and uninfected women (10/16 vs. 2/5; p=0.38). The proportion who had cervical dysplasia or HPV was significantly greater among HIV-infected than uninfected women (9/16 vs. 0/5; p=0.027). Antibody (microgram/ml), cytokine (pg/ml) and complement levels (ng/ml) were detected in all 21 women and ranged from: IgG (0.6-1695), sIgA (0.3-59), IL-2 (0.4-51), IL-10 (0-27), TNF-alpha (0.02-10), IL-1beta (1-300), IFN-gamma (8-167), IL-6 (0.3-23), C3 (less than 1 to 100), C1q (0.001-14,595), and CH50 for C4 (0-1593). Comparisons between HIV-infected and uninfected women demonstrated a trend toward higher IFN-gamma levels in HIV-infected women (p = 0.098), whereas all other variables showed no significant trend. Comparing women with cervical dysplasia or HPV to those without, higher levels of IL-2 (p=0.04), IL-1 beta (p=0.046), and IFN-gamma (p=0.009) were found. Women with vaginal infection had significantly higher CVL IFN-gamma levels than those without (p=0.025). The number of subjects in each CD4 subgroup were insufficient to detect differences.

CONCLUSIONS: Antibody, complement, and cytokines are detectable in CVL fluid. Among HIV-infected women, the trend was toward higher CVL IFN-gamma levels, but this may in part be due to the greater incidence of cervical dysplasia in these women. Increased levels of other cytokines (IL-2, IL-1beta) were noted in all women with cervical dysplasia, regardless of HIV status. The presence of vaginal infection was also associated with higher IFN-gamma levels. These data may have implications for determining the impact of HIV load in CVL fluid.

Keywords: AEGIS, HIV, Cytokines, Complement, HIV-1, HIV Infections, Interleukin-10, Papillomavirus, Human, Antigens, CD4, HIV Antibodies, Interleukin-1, Cervix Dysplasia, Interleukin-2, Interleukin-6, Immunoglobulins, Immunoglobulin A, Secretory, Tumor Necrosis Factor, Infection, Human, Female, ICA11

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MoA142