Limited secretory-IgA response in cervicovaginal secretions from HIV-1 infected, but not high risk seronegative women: Lack of correlation to genitalviral shedding

The presence and antigen specificity of IgG and secretory-IgA (s-IgA) to HI V-1 were evaluated in cervicovaginal lavages (CVL) from 26 infected and 10 highrisk seronegative women. All the seropositive women had detectable IgG recognizing several viral antigens, while a smaller percentage of women dem onstrated s-IgA to the virus. In addition, s-IgA were of limited specificit y and provided weak reactivities on Immunoblot bands; an almost constant ab sence of s-IgA to gp120 was also observed. Neither the presence nor the spe cificity of either IgG or s-IgA to the virus in CVL prevented the shedding of HIV-1 in this body fluid; in fact, viral RNA was detected in all the wom en studied and the amounts of viral shedding was unrelated to the genital a ntibody response. On the other hand, none of the high-risk seronegative women had detectable antibodies to HIV-1 in CVL of either the IgG or s-IgA isotype. Our results a) confirm an impairment of mucosal antibody response during HIV-1 infectio n and suggest that mucosal immunity is not able to prevent viral shedding i n the female genital tract and thus cannot modulate the infectivity of geni tal secretions; aa) do not provide evidence for a mucosal "memory/protectiv e'' antibody response in the genital tract of high-risk seronegative women.