Lack of association between human immunodeficiency virus type 1 antibody in cervicovaginal lavage fluid and plasma and perinatal transmission, in Thailand

To determine the association between human immunodeficiency virus type 1 (H IV)-specific antibody and RNA levels in cervicovaginal lavage (CVL) samples and plasma, zidovudine treatment, and perinatal transmission, HIV subtype E gp160-specific IgG and IgA were serially measured in a subset of 74 HIV-i nfected women in a placebo-controlled trial of zidovudine, beginning at 36 weeks of gestation. HIV IgG was detected in 100% of plasma and 97% of CVL s amples; HIV IgA was consistently detected in 62% of plasma and 31% of CVL s amples. Antibody titers in CVL samples correlated better with the RNA level in CVL samples than with plasma antibody titers, Zidovudine did not affect antibody titers, Perinatal HIV transmission was not associated with antibo dy in CVL samples or plasma. HIV-specific antibody is present in the cervic ovaginal canal of HIV-infected pregnant women; its correlation with the RNA level in CVL fluid suggests local antibody production. However, there was no evidence that these antibodies protected against perinatal HIV transmiss ion.