Session: Poster Session: Herpes Viruses
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: Cervicovaginal lavage (CVL) fluid protects against HSV, HIV & bacteria. Individual variation in this antimicrobial activity & its modulation by reproductive hormones has not been evaluated, nor have the protective mediators been characterized. This pilot study compared anti-HSV activity & levels of immune mediators in CVL obtained from women with normal ovulatory cycles (C) & women using hormonal contraception (HC). Methods: CVL was collected weekly from healthy women ages 22-33 yrs, analyzed for anti-HSV activity & levels of immune mediators. Women were excluded at any visit if they developed an STI. Results: 16 women (9 C & 7 HC) completed between 3 and 8 visits. When mean values obtained from repeat CVL from each woman were compared, HC had significantly decreased anti-HSV activity compared to C in the follicular phase (p=0.03) & trended towards reduced activity compared to the luteal phase (p=0.11). When fluid from each visit was analyzed as a discreet data point (n=94), the differences in anti-HSV activity in HC differed from that of C at both phases (K-W, p=0.0002). Anti-HSV activity positively correlated with levels of HNP 1-3 (Spearman r=0.45), lactoferrin (r=0.52), lysozyme (r=0.58) & IgA (r=0.44) & inversely with IFNα2 (r=-0.36) (all p < 0.0001). Conclusions: Despite the intra- & inter-subject variability in endogenous anti-HSV activity in CVL, there is a significant loss in activity among HC, which is associated with a reduction in protective mucosal mediators. Further study of the factors that modify this activity is ongoing. These findings may provide a biological explanation for the epidemiological findings of increased risk for STI & HSV shedding in the setting of hormonal contraception & suggest that larger prospective studies are needed.