HIV infection among lower socioeconomic strata prostitutes in Nairobi

Simonse, J. Neil; Plummer, Francis A.; Ngugi, Elizabeth; Black, Charyln; Kreiss, Joan K.; Gakinya, Michael N.; Waiyaki, Peter; D'Costa, L J; Ndinya-Achola, Jackoniah O.; Piot, Peter; Ronald, Allan R.

doi:10.1097/00002030-199002000-00007

Cited by 161 publications

(63 citation statements)

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“…HIV-specific systemic (blood) responses have been previously described in our study cohort of HIV-1-resistant sex workers (15,16); however, the vast majority of HIV-1 transmission in this population occurs across the genital mucosa during heterosexual intercourse (25). Therefore, HIV-specific CTL in the cervix might play a more direct role than do systemic responses in immunemediated protection against sexually acquired HIV-1 infection.…”

Section: Discussionmentioning

confidence: 69%

“…In an observational cohort study of the epidemiology and immunology of HIV-1 in sex workers in a slum area of Nairobi (24,25), we have identified a subgroup of women who exhibit relative resistance to HIV-1 infection (26). It is estimated that these women have over 60 unprotected sexual exposures to HIV-1 per year, despite behavioral counseling and provision of condoms; their exposure is uniformly through vaginal intercourse.…”

Section: T Is Now Recognized That There Is Variability In Susceptibmentioning

confidence: 99%

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HIV-1-Specific Mucosal CD8+ Lymphocyte Responses in the Cervix of HIV-1-Resistant Prostitutes in Nairobi

Kaul

Plummer

Kimani

et al. 2000

The Journal of Immunology

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345

228

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Understanding how individuals with a high degree of HIV exposure avoid persistent infection is paramount to HIV vaccine design. Evidence suggests that mucosal immunity, particularly virus-specific CTL, could be critically important in protection against sexually acquired HIV infection. Therefore, we have looked for the presence of HIV-specific CD8+ T cells in cervical mononuclear cells from a subgroup of highly HIV-exposed but persistently seronegative female sex workers in Nairobi. An enzyme-linked immunospot assay was used to measure IFN-γ release in response to known class I HLA-restricted CTL epitope peptides using effector cells from the blood and cervix of HIV-1-resistant and -infected sex workers and from lower-risk uninfected controls. Eleven of 16 resistant sex workers had HIV-specific CD8+ T cells in the cervix, and a similar number had detectable responses in blood. Where both blood and cervical responses were detected in the same individual, the specificity of the responses was similar. Neither cervical nor blood responses were detected in lower-risk control donors. HIV-specific CD8+ T cell frequencies in the cervix of HIV-resistant sex workers were slightly higher than in blood, while in HIV-infected donor cervical response frequencies were markedly lower than blood, so that there was relative enrichment of cervical responses in HIV-resistant compared with HIV-infected donors. HIV-specific CD8+ T cell responses in the absence of detectable HIV infection in the genital mucosa of HIV-1-resistant sex workers may be playing an important part in protective immunity against heterosexual HIV-1 transmission.

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Section: Discussionmentioning

confidence: 69%

Section: T Is Now Recognized That There Is Variability In Susceptibmentioning

confidence: 99%

HIV-1-Specific Mucosal CD8+ Lymphocyte Responses in the Cervix of HIV-1-Resistant Prostitutes in Nairobi

Kaul

Plummer

Kimani

et al. 2000

The Journal of Immunology

Self Cite

345

228

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“…The finding of IgA-mediated inhibition of HIV-1 transcytosis therefore suggests that these highly exposed, seronegative women may have developed an array of mucosal immune defenses to protect against sexual HIV-1 acquisition. It is of interest that IgA with the ability to inhibit HIV-1 transcytosis was not found in the saliva of these sex workers, because oral sex is quite uncommon in the sex worker cohort (29), while IgA purified from the saliva of seronegative subjects in the Italian discordant couple cohort was often able to inhibit transcytosis. However, it is also possible that this is a reflection of the different methods used to collect saliva specimens in the two cohorts.…”

Section: Discussionmentioning

confidence: 99%

Mucosal and Plasma IgA from HIV-1-Exposed Uninfected Individuals Inhibit HIV-1 Transcytosis Across Human Epithelial Cells

Devito

Broliden

Kaul

et al. 2000

The Journal of Immunology

225

160

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HIV-1-specific IgA has been described in the genital tract and plasma of HIV-1 highly exposed, persistently seronegative (HEPS) individuals, and IgA from these sites has been shown to neutralize HIV-1. This study examines the ability of IgA isolated from HEPS individuals to inhibit transcytosis across a tight epithelial cell layer. A Transwell system was established to model HIV-1 infection across the human mucosal epithelium. The apical-basolateral transcytosis of primary HIV-1 isolates across this mucosal model was examined in the presence and the absence of IgA isolated from the genital tract, saliva, and plasma of HEPS individuals enrolled in both a sex worker cohort in Nairobi, Kenya, and a discordant couple cohort in Italy. In the absence of IgA, HIV-1 primary isolates were actively transported across the epithelial membrane and were released on the opposite side of the barrier. These transcytosed HIV-1 particles retained their ability to infect human mononuclear cells. However, IgA purified from the mucosa and plasma of HEPS individuals was able to inhibit HIV-1 transcytosis. Inhibition was seen in three of six cervicovaginal fluid samples, five of 10 saliva samples, and three of six plasma samples against at least one of the two primary HIV-1 isolates tested. IgA from low risk, healthy control subjects had no inhibitory effect on HIV-1 transcytosis. The ability of mucosal and plasma IgA to inhibit HIV-1 transcytosis across the mucosal epithelium may represent an important mechanism for protection against the sexual acquisition of HIV-1 infection in HEPS individuals.

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“…Sex workers were enrolled from a dedicated sex worker clinic in Nairobi, Kenya (9), between 1995 and 1999. Seronegative sex workers were subdivided into three groups, based on the duration of previous HIV-1-uninfected follow-up in the cohort: those enrolled for over 3 years (thereby meeting criteria for HIV-1 resistance; group 1) (11), those enrolled for 1-3 years (group 2), and sex workers followed for less than 1 year (group 3).…”

Section: Methodsmentioning

confidence: 99%

CD8+ lymphocytes respond to different HIV epitopes in seronegative and infected subjects

Kaul¹,

Dong²,

Plummer³

et al. 2001

J. Clin. Invest.

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197

134

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HIV infection among lower socioeconomic strata prostitutes in Nairobi

Cited by 161 publications

References 0 publications

HIV-1-Specific Mucosal CD8+ Lymphocyte Responses in the Cervix of HIV-1-Resistant Prostitutes in Nairobi

HIV-1-Specific Mucosal CD8+ Lymphocyte Responses in the Cervix of HIV-1-Resistant Prostitutes in Nairobi

Mucosal and Plasma IgA from HIV-1-Exposed Uninfected Individuals Inhibit HIV-1 Transcytosis Across Human Epithelial Cells

CD8+ lymphocytes respond to different HIV epitopes in seronegative and infected subjects

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