Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, Michael G. DeGroote Institute of Infectious Diseases Research, McMaster University, Hamilton, ON, Canada.
Am J Reprod Immunol. 2014 Jun;71(6):543-54. doi: 10.1111/aji.12221. Epub 2014 Mar 12.
Women constitute almost half of HIV-infected population globally, and the female genital tract (FGT) accounts for approximately 40% of all new HIV infections worldwide. The FGT is composed of upper and lower parts, distinct in their morphological and functional characteristics. Co-factors in the genital microenvironment, such as presence of hormones, semen, and other sexually transmitted infections, can facilitate or deter HIV infection and play a critical role in determining susceptibility to HIV. In this review, we examine some of these co-factors and their potential influence. Presence of physical and chemical barriers such as epithelial tight junctions, mucus, and anti-microbial peptides can actively block and inhibit viral replication, presenting a significant deterrent to HIV. Upon exposure, HIV and other pathogens first encounter the genital epithelium: cells that express a wide repertoire of pattern recognition receptors that can recognize and directly initiate innate immune responses. These and other interactions in the genital tract can lead to direct and indirect inflammation and enhance the number of local target cells, immune activation, and microbial translocation, all of which promote HIV infection and replication. Better understanding of the dynamics of HIV transmission in the female genital tract would be invaluable for improving the design of prophylactic strategies against HIV.
女性在全球 HIV 感染者中约占一半，而女性生殖器官（FGT）约占全球所有新感染 HIV 病例的 40%。FGT 由上、下两部分组成，在形态和功能上具有明显的特征。生殖微环境中的共同因素，如激素、精液和其他性传播感染的存在，可以促进或阻止 HIV 感染，并在决定 HIV 易感性方面发挥关键作用。在这篇综述中，我们检查了其中的一些共同因素及其潜在影响。存在物理和化学屏障，如上皮紧密连接、黏液和抗微生物肽，可以主动阻止和抑制病毒复制，对 HIV 具有显著的抑制作用。暴露后，HIV 和其他病原体首先遇到生殖道上皮：这些细胞表达广泛的模式识别受体，可以识别并直接启动先天免疫反应。生殖道中的这些和其他相互作用可导致直接和间接炎症，并增加局部靶细胞、免疫激活和微生物易位的数量，所有这些都促进了 HIV 的感染和复制。更好地了解女性生殖道中 HIV 传播的动态，对于改进预防 HIV 的策略设计将是非常宝贵的。
