Unique Vaginal Cells Facilitate HIV Infection and Persistence

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https://medicalresearch.com/infections/hiv/unique-vaginal-cells-facilitate-hiv-infection-and-persistence/42312/

MedicalResearch.com Interview with:

Manish Sagar, MD Assistant Professor of Medicine, Boston University School of Medicine Boston MA 

Dr. Sagar

Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA 

MedicalResearch.com: What is the background for this study?

Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure.  The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.

MedicalResearch.com: What are the main findings?

Response: We found that the outermost epithelial cells, termed vaginal epithelial dendritic cells, were unique compared to other previously known cell types present in the blood and other epithelia commonly used in HIV studies.  We further found that HIV was able to replicate in these vaginal epithelial dendritic cells and the types of viruses known to initiate infections replicated more efficiently compared to the general non-transmitted variants.

Finally, we found HIV DNA in vaginal epithelial dendritic cells isolated from two women who were HIV infected but successfully treated with antiretroviral drugs.

In summary, our studies suggest that the vaginal epithelial dendritic cells that we isolated have not previously been characterized. Their characterization suggests that they may be the first cell that is infected during sexual exposure, and these cells may retain virus even after treatment.  Thus, these cells are important for HIV transmission and persistence. 

MedicalResearch.com: What should readers take away from your report? 

Response: Our studies suggest that vaginal epithelial dendritic cells may be the initial cell that is infected after women are exposed to the virus during sexual contact.  In the absence of a HIV vaccine, developing novel ways to prevent infection of vaginal epithelial dendritic cells may eliminate sexual transmission to women.

We know that HIV DNA exists in infected individuals indefinitely. Our finding that HIV DNA is found in vaginal epithelial dendritic cells suggest that these cells are also one reason why HIV can persist forever even with effective treatment. This study may possibly lead to a female specific prevention drug; stopping infection of vaginal epithelial dendritic cells may prevent acquisition.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We are starting to explore if there are similar cells in foreskins. This is important because it has been well documented that circumcision reduces risk of HIV acquisition.  We hypothesize that circumcision eliminates the epithelial dendritic cells and thus HIV transmission is lower. 

No disclosures

Citation:

J Clin Invest. 2018 May 3. pii: 98943. doi: 10.1172/JCI98943. [Epub ahead of print]

HIV-1 replicates and persists in vaginal epithelial dendritic cells.
Pena-Cruz V, Agosto LM, Akiyama H, Olson A, Moreau Y, Larrieux JR, Henderson A, Gummuluru S, Sagar M.

 

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One thought on “Unique Vaginal Cells Facilitate HIV Infection and Persistence

  1. The studies that claims that circumcision reduces the risk of HIV acquisition have been criticized by professionals in many countries. Even if the claims were true, about 60 men were circumcised to prevent one HIV acquisition.
    Abstract:
    Billions of dollars to circumcise millions of African males as an HIV infection prevention have been sought, yet the effectiveness of circumcision has not been demonstrated. Data from 109 populations comparing HIV prevalence and incidence in men based on circumcision status were evaluated using meta-regression. The impact on the association between circumcision and HIV incidence/prevalence of the HIV risk profile of the population, the circumcision rates within the population and whether the population was in Africa were assessed. No significant difference in the risk of HIV infection based on the circumcision status was seen in general populations. Studies of high-risk populations and populations with a higher prevalence of male circumcision reported significantly greater odds ratios (odds of intact man having HIV) (p < .0001). When adjusted for the impact of a high-risk population and the circumcision rate of the population, the baseline odds ratio was 0.78 (95% CI = 0.56–1.09). No consistent association between presence of HIV infection and circumcision status of adult males in general populations was found. When adjusted for other factors, having a foreskin was not a significant risk factor. This undermines the justification for using circumcision as a primary preventive for HIV infection.
    Robert Van Howe. Circumcision as a primary HIV preventive: Extrapolating from the available data, from Global Public Health, volume 10, issue 5-6, 2015.

    https://www.academia.edu/36139241/Circumcision_as_a_primary_HIV_preventive_Extrapolating_from_the_available_data

    http://www.ingentaconnect.com/content/routledg/gph/2015/00000010/f0020005/art00005

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