HIV-Inducing Factor in Cervicovaginal Secretions Is Associated With Bacterial Vaginosis in HIV-1-Infected Women

• DOI: 10.1097/01.qai.0000146599.47925.e0
• Publication Date: 2005-06-14T08:00:45Z
• Authors: Jonathan A Cohn; Farhad B Hashemi; Margaret Camarca; Fanhui Kong; Jiahong Xu; Suzanne K Beckner; Andrea A Kovacs; Patricia S Reiche...; Gregory T Spear
• Keywords: Adult; Hot Temperature; Adolescent; HIV Infections; Cervix Uteri; Vaginosis, Bacterial; In Vitro Techniques; Virus Replication; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Vagina; HIV-1; Humans; Female

Certain cervicovaginal lavage (CVL) fluid samples obtained from HIV-1-infected and uninfected women stimulate in vitro HIV-1 replication. This activity, HIV-inducing factor (HIF), changes when CVL fluid is heated. We sought to confirm a previous observation that HIF was associated with bacterial vaginosis (BV).HIF was measured in unheated and heated CVL fluid obtained from HIV-1-infected women and compared with the presence of BV by Nugent scores, other genital tract conditions, and cervicovaginal HIV-1 shedding.Among the 295 women studied, 54% of CVL samples had HIF activity and 21% showed heat-stable HIF activity. In adjusted logistic regression, heat-stable HIF was associated with BV (odds ratio [OR]=51.7, 95% confidence interval [CI]: 5.0, 530.7) and with intermediate flora (OR=43.3, 95% CI: 3.6, 521.1); heat-labile HIF was not associated with BV. Neither heat-stable nor heat-labile HIF was associated with other cervicovaginal conditions nor, after controlling for plasma viral load, with genital tract HIV-1 shedding.We confirmed the association of HIF with BV and attribute it to the heat-stable component. Heat-stable activity is also associated, although less strongly, with intermediate vaginal flora. We propose that heat-stable HIF is a result of products of BV-associated bacteria.