Bacterial Colonization and Beta Defensins in the Female Genital Tract in HIV Infection
Wei Jiang, Santosh K. Ghosh, Rebecca Flyckt, Magdalena Kalinowska, David Starks, Richard Jurevic, Aaron Weinberg, Michael M. Lederman and Benigno Rodriguez
Affiliation: Division of Infectious Diseases, Department of Medicine, Center for AIDS Research, Case Western Reserve University and University Hospitals/Case Medical Center, 2109 Adelbert Rd, CWRU BRB1048B, 4984. Cleveland, OH, 44106, USA.
Keywords: HIV, Bacterial 16S rDNA, beta defensins, Cervicovaginal lavage, Lactobacillus, CVL, DNA, CD4+, vaginal bacterial flora, species.
Beta defensins are antimicrobial peptides that serve to protect the host from microbial invasion at skin and
mucosal surfaces. Here we explore the relationships among beta defensin levels, total bacterial colonization, and
colonization by bacterial vaginosis (BV)-related bacteria and lactobacilli in the female genital tract in HIV infected
women and healthy controls. Cervicovaginal lavage (CVL) samples were obtained from 30 HIV-infected women and 36
uninfected controls. Quantitative PCR assays were used to measure DNA levels of bacterial 16S ribosomal DNA
(reflective of total bacterial load), and levels of three BV-related bacteria, three Lactobacillus species (L. crispatus, L.
iners and L. jensenii), and total Lactobacillus levels in CVL. Levels of human beta defensins (hBD-2 and hBD-3) were
quantified by ELISA. In viremic HIV+ donors, we found that CVL levels of bacterial 16S rDNA were significantly
increased, and inversely correlated with peripheral CD4+ T cell counts in HIV+ women, and inversely correlated with age
in both HIV+ women and controls. Although CVL DNA levels of BV-associated bacteria tended to be increased, and
CVL levels of Lactobacillus DNAs tended to be decreased in HIV+ donors, none of these differences was significant.
CVL levels of hBD-2 and hBD-3 were correlated and were not different in HIV+ women and controls. However,
significant positive correlations between hBD-3 levels and total bacterial DNA levels in controls were not demonstrable in
HIV+ women; the significant positive correlations of hBD2 or hBD-3 and three Lactobacillus species in controls were
also not demonstrable in HIV+ women. These results suggest that HIV infection is associated with impaired regulation of
innate defenses at mucosal sites.
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