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| Author(s): |
Carla Andreia Baggetti Ferraz de Lima
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2008-01-14 |
| Examining board members: |
Aluisio Augusto Cotrim Segurado;
Iara Moreno Linhares;
Claudio Sergio Pannuti
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| Advisor: | Aluisio Augusto Cotrim Segurado |
| Abstract | |
The sexual route is the main means of transmission of the human immunodeficiency virus (HIV). With the increasing numbers of HIV-infected women, the investigation of particular biological features of HIV infection in the genital tract has become more important. To evaluate HIV genital shedding during the menstrual cycle, we collected cervicovaginal lavages (CVL) from 17 women, assisted at an HIV outpatient clinic in São Paulo, in different hormonal phases during 2 cycles. HIV-RNA and proviral DNA shedding were quantified using RT-PCR and a TaqMan real-time PCR assay, respectively. In addition, patients were screened for genital coinfections and had their HIV plasma viral loads and CD4+ cell counts assessed. Cell-free HIV-RNA and proviral DNA shedding were found in 18.8% and 31.3% of women. All patients who shed HIV-RNA were also shown to present detectable proviral DNA in their CVL, including one woman with undetectable HIV plasma viral load. No significant difference in viral shedding was seen among menstrual cycle phases. Six patients from the cohort, who exhibited genital coinfections previous to admission to the study, had their HIV genital shedding compared at time of coinfection and after its resolution. In two of them proviral DNA shedding was higher at the time of coinfection, caused by Streptococcus sp and Ureaplasma. No cell-free HIV-RNA shedding was detected in coinfected patients. Our results may contribute to the understanding of HIV sexual infectivity from women and emphasize the need for adherence to protected sexual practices in order to avoid viral transmission. (AU) | |