Increased Risk of Intrauterine Transmission of HIV-1 Associated With Granulocyte Elastase in Endocervical Mucus

Identification of differentially expressed proteins in the cervical mucosa of HIV-1-resistant sex workers

Novel tools are necessary to understand mechanisms of altered susceptibility to HIV-1 infection in women of the Pumwani Sex Worker cohort, Kenya. In this cohort, more than 140 of the 2000 participants have been characterized to be relatively resistant to HIV-1 infection. Given that sexual transmission of HIV-1 occurs through mucosal surfaces such as that in the cervicovaginal environment, our hypothesis is that innate immune factors in the genital tract may play a role in HIV-1 infection resistance. Understanding this mechanism may help develop microbicides and/or vaccines against HIV-1. A quantitative proteomics technique (2D-DIGE: two-dimensional difference in-gel electrophoresis) was used to examine cervical mucosa of HIV-1 resistant women ( n = 10) for biomarkers of HIV-1 resistance. Over 15 proteins were found to be differentially expressed between HIV-1-resistant women and control groups ( n = 29), some which show a greater than 8-fold change. HIV-1-resistant women overexpressed several antiproteases, including those from the serpin B family, and also cystatin A, a known anti-HIV-1 factor. Immunoblotting for a selection of the identified proteins confirmed the DIGE volume differences. Validation of these results on a larger sample of individuals will provide further evidence these biomarkers are associated with HIV-1 resistance and could help aid in the development of effective microbicides against HIV-1.

Update: preventing mother-to-child transmission of HIV

The success of antiretroviral therapies for prevention of mother-to-child transmission of HIV in the developed world has prompted a wide array of research efforts, from improved implementation of voluntary counseling and testing programs to innovative approaches for short-course peripartum prophylaxis to understanding the dynamics of HIV transmission via breastfeeding. Clinical trials of modified short-course peripartum regimens which are applicable to resource-limited areas are demonstrating much lower transmission rates and preliminary data are emerging on limiting transmission via breastfeeding. Some of the most recent data on these topics are reviewed. Primary prevention of HIV in women of childbearing age combined with efforts to prevent mother-to-child transmission of HIV offer the best hope for addressing the burden of HIV in women and children.