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Publications HIV-1 specific mucosal IgA in a cohort of HIV-1 resistant Kenyan prostitutes R. KAUL, D. TRABATTONI, J. J. BWAYO, D. ARIENTI, M. CLERICI, F. A. PLUMMER. Dept. of Medical Microbiology, University of Nairobi, Nairobi, Nairobi, Kenya University of Milan, Milan, Italy University of Manitoba, Winnipeg MB, Canada Background and Objectives: Initial contact with HIV-1 takes place at the genital mucosa for most exposed individuals. The role of mucosal immune factors in HIV-1 susceptibility remains poorly defined, but virus specific IgA has been described in the genital tract of highly-exposed, HIV-1 seronegative individuals. The objective of this study was to examine HIV-1 specific mucosal IgA in a cohort of HIV-1 resistant female prostitutes in Nairobi, Kenya. Methods: HIV-1 specific mucosal IgA and IgG, and systemic T-helper responses to HIV-1 envelope peptides, were studied in HIV-1 resistant (N = 21) and infected (N = 19) prostitutes enrolled from a sex worker clinic in the Pumwani slum of Nairobi; and in seronegative control women (N = 28) enrolled from a nearby family planning clinic. A simple HIV-1 "risk score" was calculated for seronegative controls, based on HIV-1 risk-taking behaviours. Results: Mucosal HIV-1 specific IgA was present in the genital tract of 16 (76%) resistant and 5 (26%) seropositive prostitutes, and 3 (11%) control seronegatives (P < 0.001). No significant association was found between resistance and salivary IgA (29% vs 5% and 14% respectively; P = 0.12). Mucosal HIV-1 specific IgG was present in the genital tract of all seropositive and no resistant subjects. The 3 seronegative controls with HIV-1 specific genital IgA had significantly elevated risk scores (6.7 vs 3.5; P = 0.004). While T-helper responses to antigenic HIV-1 envelope peptides were found in half the resistant women, these responses did not correlate with the presence of salivary or genital IgA. Conclusion: HIV-1 specific IgA is present in the genital tract of most highly-exposed, HIV-1 uninfected Kenyan prostitutes. It is also present in a minority of lower risk seronegative controls, where it is highly associated with HIV risk-taking behaviours. These data suggest a role for mucosal virus-specific humoral responses in resistance to HIV-1, independent of host cellular responses.
12th WORLD AIDS CONFERENCE, Geneva, Switzerland, June 28-July 3, 1998.
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