Cervical shedding of HIV-1 DNA may influence HIV-1 sexual transmission. HIV-1 DNA was detected in 250 (80%) of 316 and 207 (79%) of 259 cervical cytobrush specimens from 56 US and 80 Kenyan women, respectively. Plasma HIV-1 RNA concentration was associated with increased HIV-1 DNA shedding among US and Kenyan women. Kenyan women had higher cervicovaginal concentrations of proinflammatory interleukins (IL)-1β, IL-6, IL-8, and anti-inflammatory secretory leukocyte protease inhibitor compared with US women (all P< 0.01). HIV-1 DNA shedding was associated with increased concentrations of IL-1β and IL-6 and lower secretory leukocyte protease inhibitor among US women but not Kenyan women.

BACKGROUND

Cervical HIV-1 DNA shedding is frequently detected among HIV-1–infected women (26%–86% of specimens) 1–3 despite potent suppressive antiretroviral therapy (ART) and may be a contributor to sexual HIV-1 transmission. The mechanisms responsible for HIV-1 DNA shedding are not well understood; elucidation of these mechanisms could be useful for prevention of sexual and perinatal HIV-1 transmission.