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Copyright © 2008 Randolph et al; licensee BioMed Central Ltd. A predominance of R5-like HIV genotypes in vaginal secretions is associated with elevated plasma HIV-1 RNA levels and the absence of anti-retroviral therapy Tara C Randolph,1 Patricia J Kissinger,2 Rebecca A Clark,1 Nedra Lacour,1 and Angela M Amedee  11Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA, USA 2School of Public Health and Tropical Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA Corresponding author.Tara C Randolph: trand1/at/lsuhsc.edu; Patricia J Kissinger: kissing/at/tulane.edu; Rebecca A Clark: rclark/at/lsuhsc.edu; Nedra Lacour: nlacou/at/lsuhsc.edu; Angela M Amedee: aamede/at/lsuhsc.edu Received May 2, 2008; Accepted July 29, 2008. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. | ||||
Abstract HIV expressed in genital secretions provides the inoculum from which transmitting variants are selected, both in sexual transmission and mother-to-infant transmission during partuition. Characterization of HIV levels and genotypes found in vaginal secretions and the impact of anti-retroviral therapy (ART) on this virus can provide valuable insight for the prevention of HIV transmission. Vaginal HIV was evaluated in a cohort of 43 women attending a New Orleans HIV outpatient clinic. Predominant vaginal genotypes were characterized as R5- or X4-like by heteroduplex tracking analyses of the envelope V3 region. Most women (67.4%) shed R5-like genotypes in vaginal secretions which was associated with elevated plasma HIV levels (≥ 10,000 copies HIV-RNA/mL) and absence of ART. Because R5-like genotypes are more frequently associated with transmission, these observations suggest that the majority of women shedding HIV in genital secretions present a transmission risk. The levels of vaginal virus were similar between both groups, but shedding of X4-like genotypes was associated with lower plasma viral loads and the use of ART, suggesting that ART use may impact the genotypes of virus found in the female genital compartment. | ||||
