Cervicovaginal anti-HIV antibodies in HIV-seronegative female sex workers in Abidjan, Cote d'Ivoire

Objective: To detect anti-HIV antibodies in cervicovaginal secretions of HI V-seronegative female sex workers and to evaluate whether the presence of t hese antibodies is associated with increased sexual exposure. Methods: A cross-sectional study was carried out at a confidential clinic f or female sex workers in Abidjan, Cote d'Ivoire. The participants were 342 HIV-seronegative female sex workers in whom a cervicovaginal ravage was col lected. The main outcome measures were the detection of antibodies to HIV-1 in cervicovaginal lavages using an in-house and a commercial (Seradyn Sent inel(R); Calypte Biomedical Corporation, Berkeley, California, USA) enzyme immunoassay; the detection of semen in cervicovaginal lavages; and the asse ssment of epidemiological and biological markers of sexual exposure to HIV. Results: Cervicovaginal anti-HIV antibodies were detected in 7.3 and 29.8% of women using in-house enzyme-linked immunosorbent assay (ELISA) and Serad yn Sentinel respectively. All cervicovaginal secretions found to be positiv e by in-house ELISA were also positive by Seradyn Sentinel. In a minority o f women, ranging from 2.9% by in-house ELISA to 12.3% by Seradyn Sentinel, the anti-HIV antibodies were present in vaginal fluids that did not contain semen. Sexual exposure to HIV was similar in women with anti-HIV antibodie s in their semen-free cervicovaginal secretions compared with women without anti-HIV antibodies in their cervicovaginal secretions. Conclusions: Cervicovaginal HIV-specific antibodies were detected in a mino rity of sexually exposed HIV-seronegative female sex workers in Abidjan. Th e lack of association between increased sexual exposure to HIV and presence of cervicovaginal HIV-specific antibodies suggests that the production of genital HIV-specific antibodies in exposed seronegative women depends on th e ability of individual women to mount specific mucosal immunity to HIV ant igens, the determinants of which are currently unknown. (C) 2000 Lippincott Williams & Wilkins.