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  • Title: Shedding of HIV-1 subtype E in semen and cervico-vaginal fluid.
    Author: Sutthent R, Chaisilwattana P, Roongpisuthipong A, Wirachsilp P, Samrangsarp K, Chaiyakul P, Puthavathana P, Wasi C.
    Journal: J Med Assoc Thai; 1997 Jun; 80(6):348-57. PubMed ID: 9240008.
    Abstract:
    The uneven expansion of HIV-1 subtypes in each transmitted group raises the possibility that some viruses have less/more potential by qualitative/quantitative for heterosexual transmission compared to others. In Thailand, HIV-1 subtype E is mainly spread via heterosexual route and accounts for about 95 per cent of the infected cases. To determine whether high sexual infectivity of HIV-1 subtype E is due to the presence of a virus in genital fluid, we conducted a study to characterize shedding of HIV-1 in seminal and cervico-vaginal fluids of 30 HIV-1 subtype E infected Thai couples by PCR and virus isolation methods. All subjects had no HIV-associated diseases and other sexually transmitted diseases. HIV-1 subtype E DNA was detected in 22/30 (77.33%) of cervico-vaginal and also 22/30 (77.33%) of seminal fluid samples. The isolation rate of HIV-1 from semen and cervico-vaginal secretion was 36.67 per cent and 16.67 per cent, respectively. Number of HIV-1 subtype E DNA copies in the blood is reversely correlated with the number of blood CD4+ T cells, while that in genital fluid was not related to CD4+ T cell count. An increase in shedding of HIV- DNA subtype E in female genital tract compared to other HIV subtypes reported by other investigators might be one reason to explain the rapid spread of subtype E by heterosexual transmission in Thailand. Preliminary evidence suggests that HIV subgroups differ in both their transmissibility and virulence. In Thailand, HIV-1 subtype E (accounting for almost 95% of total HIV cases) is transmitted primarily through heterosexual sex, with a predominance of female-to-male infection. This study characterized virus shedding patterns in seminal and cervico-vaginal fluids from 30 asymptomatic husband-wife pairs from Bangkok, Thailand, known to be infected with HIV-1 subtype E. HIV-1 subtype E was detected in 22 (77.3%) cervico-vaginal and 22 (77.3%) seminal fluid samples. HIV-1 subtype B, in contrast, is found in only 30-50% of cervico-vaginal specimens; detection of subtype B in seminal specimens (70-80%) is comparable to that identified for subtype E in the present study. The isolation rate of HIV-1 was 36.67% from semen and 16.67% from cervico-vaginal secretions. The number of HIV-1 subtype E DNA copies in blood--but not in genital fluids--was inversely correlated with the number of blood CD4+ T cells. The increased shedding of HIV-1 DNA subtype E compared with other subtypes in the female genital tract presumably accounts for the rapid spread of subtype E among heterosexuals in Thailand.
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