Background: We investigated the impact of antimicrobials in cervicovaginal lavage (CVL) from HIV(+) and HIV(2) women on\r\ntarget cell infection with HIV. Since female reproductive tract (FRT) secretions contain a spectrum of antimicrobials, we\r\nhypothesized that CVL from healthy HIV(+) and (2) women inhibit HIV infection.\r\nMethodology/Principal Findings: CVL from 32 HIV(+) healthy women with high CD4 counts and 15 healthy HIV(2) women\r\nwere collected by gently washing the cervicovaginal area with 10 ml of sterile normal saline. Following centrifugation, anti-\r\nHIV activity in CVL was determined by incubating CVL with HIV prior to addition to TZM-bl cells. Antimicrobials and antigp160\r\nHIV IgG antibodies were measured by ELISA. When CXCR4 and CCR5 tropic HIV-1 were incubated with CVL from\r\nHIV(+) women prior to addition to TZM-bl cells, anti-HIV activity in CVL ranged from none to 100% inhibition depending on\r\nthe viral strains used. CVL from HIV(2) controls showed comparable anti-HIV activity. Analysis of CH077.c (clone of an R5-\r\ntropic, mucosally-transmitted founder virus) viral inhibition by CVL was comparable to laboratory strains. Measurement of\r\nCVL for antimicrobials HBD2, trappin-2/elafin, SLPI and MIP3a indicated that each was present in CVL from HIV(+) and\r\nHIV(2) women. HBD2 and MIP3a correlated with anti-HIV activity as did anti-gp160 HIV IgG antibodies in CVL from HIV(+)\r\nwomen.\r\nConclusions/Significance: These findings indicate that CVL from healthy HIV(+) and HIV(2) women contain innate and\r\nadaptive defense mechanisms that inhibit HIV infection. Our data suggest that innate endogenous antimicrobials and HIVspecific\r\nIgG in the FRT can act in concert to contribute toward the anti-HIV activity of the CVL and may play a role in\r\ninhibition of HIV transmission to women.
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