ART Impacts How HIV Establishes Itself in the Female Reproductive Tract

FEBRUARY 25, 2016
Caitlyn Fitzpatrick
hospital medicine, infectious disease, HIV, AIDS, ART, OBGYN, women’s health, sexual health, human immunodeficiency virus, antiretroviral therapy, reproductive health, HIV transmissionThe human immunodeficiency virus (HIV) is no longer the death sentence it was when the virus was first discovered in 1983. Although patients are living better, longer lives, finding a cure to the disease remains a top priority.

Researchers at the University of North Carolina (UNC) are actively on the hunt for an HIV cure and, for the first time, they identified how antiretroviral therapy (ART) affects the infection in the female reproductive tract. MD Magazine spoke with Angela Wahl, PhD, an assistant professor of infectious diseases at UNC, to dive deeper into the clinical implications and what this means for a condition that affects nearly 35 million people worldwide.

The clinical trial, HBTN052, recently revealed that when patients received ART, there was a 93% reduction in HIV transmission to their partners. Going off of those results, the UNC team used humanized mice models to understand the infection. Regardless of vaginal or rectal entry, HIV quickly establishes itself in the female reproductive tract. Wahl said that they observed an initial influx in CD4 T-cells in this area, which are the cells that the virus wants to infect. The problem here is that the cells that are supposed to protect against infection, CD8 T-cells, do not make it to the tract fast enough so HIV has time to establish itself. As expected, ART caused reduced levels of cell-free HIV in both the blood and the cervical vaginal secretions during antiretroviral therapy.

“What we weren’t anticipating were that when we looked at mice that were treated with antiretroviral therapy and had suppressed levels of cell-free virus both in the peripheral blood and cervical vaginal secretions, that we would still find infected cells that were producing viral RNA, both in the cervical vaginal secretions and in the female reproductive tract,” Wahl explained.

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