Immunologic, Virologic, and Pharmacologic Characterization of the Female Upper Genital Tract in HIV-Infected Women

Abstract

A comparative analysis of cellular and soluble markers of immune activation in HIV-infected women on combination antiretroviral therapy (cART) showed that the upper (UGT) compared to the lower female genital (LGT) tract was characterized by higher frequencies of potential HIV target cells and increased inflammatory molecules. Despite the activated UGT milieu, HIV RNA could not be detected in paired samples of plasma, cervicovaginal (CVL) or endometrial lavage (EML). As ARV concentrations were ≥3 fold higher in the endometrium than the in the lower genital tract, high ARV penetration and/or metabolism may limit viral replication in the UGT