Sexual Transmission of Human Immunodeficiency Virus

Peterman, Thomas A.; Curran, James W.

doi:10.1001/jama.1986.03380160080024

Cited by 92 publications

(5 citation statements)

References 62 publications

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“…Understanding the innate immune system in the FRT is of critical importance, because sexually transmitted infections (STIs) are a major worldwide health problem (16, 17). Despite extensive efforts at control, only limited success has been achieved in dealing with a growing list of STIs including Herpes simplex virus type 2, Chlamydia trachomatis , group B streptococcus, and acquired immunodeficiency syndrome (AIDS) (18), which devastate both adults and newborns. Estimated new cases of STI in the USA alone are placed at more than 15 million per year.…”

Section: Introductionmentioning

confidence: 99%

Innate and adaptive immunity in female genital tract: cellular responses and interactions

Wira

Fahey

Sentman

et al. 2005

Immunological Reviews

448

468

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The mucosal immune system in the female reproductive tract (FRT) has evolved to meet the unique requirements of dealing with sexually transmitted bacterial and viral pathogens, allogeneic spermatozoa, and the immunologically distinct fetus. Analysis of the FRT indicates that the key cells of the innate and adaptive immune systems are present and functionally responsive to antigens. Acting through Toll-like receptors in the Fallopian tubes, uterus, cervix, and in the vagina, epithelial cells, macrophages, natural killer cells, and neutrophils confer protection through the production of chemokines and cytokines, which recruit and activate immune cells, as well as bactericidal and virucidal agents, which confer protection at times when adaptive immunity is downregulated by sex hormones to meet the constraints of procreation. The overall goal of this paper is to define the innate immune system in the FRT and, where possible, to define the regulatory influences that occur during the menstrual cycle that contribute to protection from and susceptibility to potential pathogens. By understanding the nature of this protection and the ways in which innate and adaptive immunity interact, these studies provide the opportunity to contribute to the foundation of information essential for ensuring reproductive health.

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Section: Introductionmentioning

confidence: 99%

Innate and adaptive immunity in female genital tract: cellular responses and interactions

Wira

Fahey

Sentman

et al. 2005

Immunological Reviews

448

468

View full text Add to dashboard Cite

show abstract

“…Sexually transmitted diseases (STDs) are a major worldwide health problem that compromise reproductive fecundity as well as cut short the lives of millions of men, women and children 1,2 . Despite extensive efforts, only limited success has been achieved in dealing with STDs, including herpes simplex virus type 2 (HSV‐2), Chlamydia trachomatis , group B streptococcus and human immunodeficiency virus [(HIV), the causative agent of acquired immune‐deficiency syndrome (AIDS)], 3 which collectively devastate both adults and newborns. It is now well recognized that the heterosexual transmission of HIV, which is reponsible for 70–80% of the new cases identified in the last 2 years, is the major route of infection worldwide 4,5 .…”

mentioning

confidence: 99%

The innate immune system: gatekeeper to the female reproductive tract

Wira

Fahey

2003

Immunology

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Sexually transmitted diseases (STDs) are a major worldwide health problem that compromise reproductive fecundity as well as cut short the lives of millions of men, women and children. 1,2 Despite extensive efforts, only limited success has been achieved in dealing with STDs, including herpes simplex virus type 2 (HSV-2), Chlamydia trachomatis, group B streptococcus and human immunode®ciency virus [(HIV), the causative agent of acquired immune-de®ciency syndrome (AIDS)], 3 which collectively devastate both adults and newborns. It is now well recognized that the heterosexual transmission of HIV, which is reponsible for 70±80% of the new cases identi®ed in the last 2 years, is the major route of infection worldwide. 4,5 With the identi®cation of HIV in semen and cervical secretions, 6±8 AIDS is now the major life-threatening STD. 9,10 As strategies are developed to prevent and effectively treat this growing global health problem, understanding the immune system in the female reproductive tract and the way it is regulated by the endocrine system has particular importance.The adaptive and innate immune systems are the two key branches that determine host protection throughout the female reproductive tract and at other mucosal surfaces, including the respiratory, gastrointestinal and urinary tracts. Adaptive immunity encompasses the recognition and response to antigens with resultant protection that is gradual, very speci®c and mediated through antibodies and/or T cells. In contrast, innate immune responses use non-speci®c mechanisms that are inherent, rapid and mediated by germline-encoded receptors. 11

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“…Some have recommended reducing the number of sexual partners, avoiding high-risk sexual acts such as anal sex, and educating the public on the advantages of the use of condoms and voluntary HIV testing and counseling. [3][4][5][6] Others have ad-vised uninfected persons to have sex with only low-risk or uninfected partners. 7,8 Most of these investigators did not quantify risks in a way that would help compare the effects of their choices.…”

mentioning

confidence: 99%