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| Abstract #291 - Mycobacterium tuberculosis shedding in semen increases heterosexual transmission rate of HIV-1 | ||||
| Authors: Presenting Author: Ms Arshi Munawwar - AIIMS | ||||
| Additional Authors: Dr. A Lisco, Dr. C Vanpouille, Dr. J C Grivel, Dr. S K Sharma, Dr. L B Margolis, Dr. Sarman Singh, | ||||
| Aim: Tuberculosis is a well known co-morbidity of HIV-1 infection, but its role in heterosexual transmission of HIV is least studied. Infection and dissemination of HIV-1 through the female body depends on the load and phenotype of HIV-1 in semen and on the activation/differentiation status of mucosal CD4 t-cells. Hypothesis: Tuberculosis co-infection increases heterosexual transmission rate of HIV-1. | ||||
| Method / Issue: Methods: The study cohort consisted 30 HIV positive males of which 21 were concordant and 9 were HIV positive and their wives negative (discordant). HIV tests were done as per standard WHO guidelines. HIV-1 load was detected using real time PCR or NASBA (gag gene). Mtb was amplified using real-time PCR (IS6110 gene) in semen samples.In blood and semen all 21 cytokines were estimated using luminex multiplex assay | ||||
| Results / Comments: Results: HIV-1 load was detected in all 30 blood and semen samples. HIV-1 viral load in semen [median load, (ML) 3.735 log 10 cp/mL] correlated with absolute CD4+ cell count [median count 370.5]. Mtb DNA [median load, (ML) 1.69 log10 cp/mL] was detected in semen of 63.3% [19/30] HIV-1+ subjects. HIV-Tb shedding associated with 81% (17/21) HIV positivity of female spouse (concordance). However no significant difference was seen in HIV viral load of TB shedders and TB non shedders in semen. In support of our hypothesis,Cytokine spectrum varied in TB shedders vs TB non-shedders. In TB shedders 4 CKs upregulated (Eotaxin, MIG, GM-CSF,TGF-b)(p< 0.05) while 15 CKs had similar profile irrespective TB shedding (IL1a, IL-1β, IL-6,IL8,IL-16,MIP-1a,MIP3a,RANTES, MCP1, IP10, SDF1b) (p< 0.05) (IL-7,IL-15,MIP-1b,TNF-alpha,) (p>0.05). In blood plasma of HIV-TB shedders 2 CKs (IL-2 and MIP-1a) (p< 0.05) and in later (IL-7 and MIP-3a) upregulated. [RANTES, Eotaxin, IP10 and MCP-1] (p< 0.05)upregulation associated with seminal TB shedding. | ||||
| Discussion: Conclusions: Shedding of the mycobacterial DNA in semen of HIV-1 infected males was strongly (81%) associated with HIV-1 transmission to their female spouses. | ||||
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