Improved understanding of factors which affect infectivity of women may lead to development of preventive interventions for heterosexual and perinatal transmission. The major goal of this project is to define the prevalence, quantity, and correlates of HIV DNA and RNA in cervical and vaginal secretions of HIV seropositive women. A cross-sectional study of 400 prostitutes in Mombasa, Kenya will be conducted to evaluate the association between genital mucosal HIV and CD4 level, hormonal contraception, pregnancy, cervical ectopy, sexually-transmitted diseases, local inflammation, pH, estradiol, progesterone, and vitamin A. In addition, three substudies will be conducted. In the first, 300 women with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichmonas vaginalis, Candida ssp., or bacterial vaginosis (and, in particular, absence of hydrogen peroxide producing lactobacilli) will be evaluated before and after treatment of the genital infection to document reduction in HIV shedding following resolution of sexually-transmitted diseases. In the second, 60 women will be studied before and after institution of hormonal contraception with either oral contraceptive pills or injectable progesterone to determine whether method of contraception has a measurable effect on HIV shedding. In the third, a group of 10 women will be evaluated daily for one month to define the pattern of cervical and vaginal HIV and HIV specific antibodies in relation to menstrual cycle. In this proposed study the researchers will characterize factors which affect HIV infectivity in women and may lead to new intervention strategies to prevent transmission.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI039996-03
Application #
2672787
Study Section
AIDS and Related Research Study Section 2 (ARRB)
Project Start
1996-08-15
Project End
2000-07-31
Budget Start
1998-08-01
Budget End
1999-07-31
Support Year
3
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Benki, Sarah; Mostad, Sara B; Richardson, Barbra A et al. (2008) Increased levels of HIV-1-infected cells in endocervical secretions after the luteinizing hormone surge. J Acquir Immune Defic Syndr 47:529-34
Manhart, Lisa E; Mostad, Sara B; Baeten, Jared M et al. (2008) High Mycoplasma genitalium organism burden is associated with shedding of HIV-1 DNA from the cervix. J Infect Dis 197:733-6
Baeten, Jared M; McClelland, R Scott; Wener, Mark H et al. (2007) Relationship between markers of HIV-1 disease progression and serum beta-carotene concentrations in Kenyan women. Int J STD AIDS 18:202-6
Baeten, Jared M; Wener, Mark H; Bankson, Daniel D et al. (2006) HIV-1 infection alters the retinol-binding protein:transthyretin ratio even in the absence of the acute phase response. J Nutr 136:1624-9
McClelland, R Scott; Baeten, Jared M; Richardson, Barbra A et al. (2006) A comparison of genital HIV-1 shedding and sexual risk behavior among Kenyan women based on eligibility for initiation of HAART according to WHO guidelines. J Acquir Immune Defic Syndr 41:611-5
Drain, Paul K; Baeten, Jared M; Overbaugh, Julie et al. (2006) Low serum albumin and the acute phase response predict low serum selenium in HIV-1 infected women. BMC Infect Dis 6:85
Benki, Sarah; McClelland, R Scott; Emery, Sandra et al. (2006) Quantification of genital human immunodeficiency virus type 1 (HIV-1) DNA in specimens from women with low plasma HIV-1 RNA levels typical of HIV-1 nontransmitters. J Clin Microbiol 44:4357-62
McClelland, R Scott (2005) Effect of exogenous hormones. J Acquir Immune Defic Syndr 38 Suppl 1:S38-9
Baeten, Jared M; McClelland, R Scott; Corey, Lawrence et al. (2004) Vitamin A supplementation and genital shedding of herpes simplex virus among HIV-1-infected women: a randomized clinical trial. J Infect Dis 189:1466-71
Baeten, Jared M; Richardson, Barbra A; Bankson, Daniel D et al. (2004) Use of serum retinol-binding protein for prediction of vitamin A deficiency: effects of HIV-1 infection, protein malnutrition, and the acute phase response. Am J Clin Nutr 79:218-25

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