Browsing by Author "Passmore, Jo-Ann Shelley."
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Item Broadly neutralizing antibody specificities detected in the genital tract of HIV-1 infected women.(Wolters Kluwer., 2016) Mkhize, Nonhlanhla N.; Durgiah, Raveshni.; Ashley, Vicki C.; Archary, Derseree.; Garrett, Nigel Joel.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Moore, Penelope L.; Yates, Nicole L.; Passmore, Jo-Ann Shelley.; Tomaras, Georgia D.; Morris, Lynn.Abstract available in PDF file..Item CCR5 expression, haplotype and immune activation in protection from infection in HIV‐exposed uninfected individuals in HIV serodiscordant relationships.(John Wiley & Sons., 2017) Jaumdally, Shameem Z.; Picton, Anabela.; Tiemessen, Caroline Tanya.; Paximadis, Maria.; Jaspan, Heather B.; Gamieldien, Hoyam.; Masson, Lindi.; Coetzee, David.; Williamson, Anna-Lise.; Little, Francesca.; Gumbi, Pamela Phumelele.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Cervicovaginal inflammation facilitates acquisition of less infectious HIV variants.(Oxford University Press., 2017) Selhorst, Philippe.; Masson, Lindi.; Ismail, Sherazaan D.; Samsunder, Natasha.; Garrett, Nigel Joel.; Mansoor, Leila Essop.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.; Williamson, Carolyn.Abstract available in pdf.Item Distinct genital tract HIV-specific antibody profiles associated with Tenofovir gel.(Nature., 2016) Archary, Derseree.; Seaton, Kelly E.; Passmore, Jo-Ann Shelley.; Werner, Lise.; Deal, Aaron W.; Dunphy, Laura J.; Arnold, Kelly B.; Yates, Nicole L.; Lauffenburger, Douglas A.; Bergin, Philip.; Liebenberg, Lenine Julie.; Samsunder, Natasha.; Mureithi, Marianne W.; Altfeld, Marcus.; Garrett, Nigel Joel.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Morris, Lynn.; Tomaras, Georgia D.Abstract available in PDF file.Item Genital inflammation and the risk of HIV acquisition in women.(Oxford University Press., 2015) Masson, Lindi.; Passmore, Jo-Ann Shelley.; Liebenberg, Lenine Julie.; Werner, Lise.; Baxter, Cheryl.; Arnold, Kelly B.; Williamson, Carolyn.; Little, Francesca.; Mansoor, Leila Essop.; Naranbhai, Vivek.; Lauffenburger, Douglas A.; Ronacher, Katharina.; Walzl, Gerhard.; Garrett, Nigel Joel.; Williams, Brent L.; Couto-Rodriguez, Mara.; Hornig, Mady.; Lipkin, Walter Ian.; Grobler, Anna Christina.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.Abstract available in pdf.Item Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women.(Nature Publishing Group., 2018) McKinnon, Lyle R.; Liebenberg, Lenine Julie.; Yende-Zuma, Fortunate Nonhlanhla.; Archary, Derseree.; Ngcapu, Sinaye.; Sivro, Aida.; Nagelkerke, Nico.; Garcia Lerma, Gerardo.; Kashuba, Angela D. M.; Masson, Lindi.; Mansoor, Leila Essop.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Genital inflammation, immune activation and risk of sexual HIV acquisition.(Wolters Kluwer Health., 2016) Passmore, Jo-Ann Shelley.; Jaspan, Heather B.; Masson, Lindi.Abstract available in pdf.Item Genital tract inflammation during early HIV-infection predicts higher plasma viral load set point in women.(Oxford University Press., 2011) Roberts, Lindi.; Passmore, Jo-Ann Shelley.; Mlisana, Koleka Patience.; Williamson, Carolyn.; Little, Francesca.; Bebell, Lisa M.; Walzl, Gerhard.; Abrahams, Melissa-Rose.; Woodman, Zenda.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.Background. The biggest challenge in human immunodeficiency virus type 1 (HIV-1) prevention in Africa is the high HIV-1 burden in young women. In macaques, proinflammatory cytokine production in the genital tract is necessary for target cell recruitment and establishment of simian immunodeficiency virus (SIV) infection following vaginal inoculation. The purpose of this study was to assess if genital inflammation during early HIV-1 infection predisposes women to rapid disease progression. Methods. Inflammatory cytokine concentrations were measured in cervicovaginal lavage (CVL) from 49 women 6, 17, 30, and 55 weeks after HIV-1 infection and from 22 of these women before infection. Associations between genital inflammation and viral load set point and blood CD4 cell counts 12 months after infection were investigated. Results. Elevated genital cytokine concentrations 6 and 17 weeks after HIV-1 infection were associated with higher viral load set points and, to a lesser extent, with CD4 depletion. CVL cytokine concentrations during early infection did not differ relative to preinfection but were elevated in women who had vaginal discharge, detectable HIV-1 RNA in their genital tracts, and lower blood CD4 counts. Conclusion. Genital inflammation during early HIV-1 infection was associated with higher viral load set point and CD4 depletion, which are markers of rapid disease progression. Strategies aimed at reducing genital inflammation during early HIV-1 infection may slow disease progression.Item Genital—systemic chemokine gradients and the risk of HIV acquisition in women.(Wolters Kluwer Health., 2017) Liebenberg, Lenine Julie.; Masson, Lindi.; Arnold, Kelly B.; McKinnon, Lyle R.; Werner, Lise.; Proctor, Elizabeth.; Archary, Derseree.; Mansoor, Leila Essop.; Lauffenburger, Douglas A.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Impact of injectable hormonal contraceptives on innate immune environment in the genital tract in women at high risk for HIV-1 infection.(2015) Ngcapu, Sinaye.; Abdool Karim, Quarraisha.; Passmore, Jo-Ann Shelley.Abstract available in PDF file.Item The impact of sexually transmitted infections (STI) and genital tract inflammation on HIV-1 acquisition and rate of disease progression in subtype C infected women.(2014) Mlisana, Koleka Patience.; Kharsany, Ayesha Bibi Mahomed.; Passmore, Jo-Ann Shelley.Introduction: Women carry more than half the burden of HIV disease globally and this burden is even higher in sub-Saharan Africa (SSA). Young women, in particular, are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviours and factors associated with ability to negotiate safe sex and condom use is one of the key elements in curbing the spread of HIV. Sexually transmitted infections (STI) and bacterial vaginosis (BV), which cause female genital tract inflammation, have been identified as key drivers of the HIV epidemic. This inflammation, which is also present in the absence of symptoms, is associated with increased susceptibility to HIV infection. Although syndromic management of symptomatic STIs or BV at the first encounter with a health care provider is an important public health measure, its effectiveness is minimised because a substantial proportion of individuals have either asymptomatic infections or fail to recognise signs and symptoms of STI and are therefore excluded. Most new HIV infections in SSA occur among young people and particularly among young girls. Prompt diagnosis of acute HIV infection (AHI) is critical and benefits the individual as well as providing opportunities for public health intervention. In South Africa, the majority of HIV infections are due to infection with HIV-1 subtype C for which there is limited data compared to subtype-B HIV-1 infections. The overall aim of this study was to assess the impact of BV, STIs, and associated genital tract inflammation on acquisition of HIV-1 subtype C infections; and evaluate the rate of subsequent disease progression in women. The objectives were: i. to investigate STIs and genital tract inflammation as risk factors for HIV infection in high risk women and adequacy of syndromic management; ii. to evaluate the challenges associated with diagnosing recently acquired (acute) HIV infection in a subtype C prevalent population; iii. and to evaluate the relationship between clinical disease progression and genital and or systemic inflammation in high-risk women who became infected with HIV. We assessed the adequacy of syndromic diagnosis of STIs, compared with laboratory diagnosis of STIs, and evaluated the association between STI diagnosis and the risk of HIV acquisition in a cohort of high-risk women. Genital cytokine profiles and the degree of inflammation associated with common STIs and bacterial vaginosis were assessed. The most common signs and symptoms of acute HIV infection (AHI) were described and a clinical algorithm to identify acute HIV cases was developed. We investigated rates of HIV disease progression of subtype C–infected South African women. Methods: The CAPRISA 002 study was a prospective cohort study established to examine the pathogenesis and natural history of HIV-1 subtype C infection and to describe the immunologic, virologic and clinical characteristics of acute and early infection in KwaZulu Natal, South Africa. A total of 775 high-risk women were screened for HIV infection, and 245 HIV-uninfected women were enrolled into the study. At each monthly visit for a total of 24 months behavioural and clinical data were collected. Cervico-vaginal lavage (CVL) samples were collected at enrolment and at each six month follow-up visits and were tested for STI pathogens (including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus type 2 (HSV-2) and Trichomonas vaginalis) and bacterial vaginosis. Forty-two cytokines were measured from the CVL and 13 from the plasma samples at enrolment. All women received monthly HIV-1 antibody and RNA testing and were assessed for AHI. Signs and symptoms at the visit with HIV-1 antibody or HIV-1 RNA positive test were compared to HIV negative visits. Logistic regression identified clinical predictors of AHI and a model-based score was assigned to each predictor to create a risk score for every woman. All women who seroconverted were followed up for more than five years and monitored for HIV disease progression. Rapid disease progression was defined as CD4+ T cell count decline to <350 cells/μl within two years post-infection. Serial clinical and laboratory assessments were compared using survival analysis and logistic regression models. CAPRISA had established several cohorts of HIV negative women to determine the feasibility of establishing cohorts and sites for HIV biomedical prevention trials. Women seroconverting in these studies were referred to the CAPRISA 002 study for longitudinal follow-up for HIV post seroconversion. Results: In this study, the HIV-1 prevalence at screening was 59.6% (95% CI: 55.9% to 62.8%). During a total of 390 person-years of follow-up, 28 new infections occurred, yielding a seroincidence rate of 7.2 (95% CI: 4.5 to 9.8) per 100 person-years. A total of 62 participants, including seroconvertors from other CAPRISA cohorts, were enrolled into the acute HIV infection Women from the HIV-1 negative cohort generally demonstrated a high level of knowledge on HIV/AIDS, and 60.3% reported use of condoms. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners; p = 0.36), whilst self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (20.8% versus 53.9%; p=0.01). An important finding was that vaginal discharge was a poor predictor of laboratory-diagnosed STIs, as only 12.3% of women (25/204) who had a laboratory-confirmed discharge causing pathogen had clinical evidence of a discharge (yielding a sensitivity of 12.3% and a specificity of 93.8%). CVL cytokine concentrations did not differ between women with asymptomatic or symptomatic STIs; and were elevated in women with either asymptomatic or symptomatic STIs compared to women with no STIs or BV. Women with chlamydia or gonorrhoea had the highest genital cytokine concentrations, with 17/42 and 14/42 of the cytokines measured in CVL being up-regulated compared with women with no infections, respectively. While BV was associated with elevated pro-inflammatory cytokine concentrations in CVL, women with BV had lower levels of chemokines and haematopoietic cytokines than women with no infections or BV. HSV-2 reactivation was inflammatory, but yielded a comparatively lower level of inflammation than Chlamydia or gonnorhoea. Trichomoniasis, despite being relatively common in this cohort, did not cause significant changes in genital tract cytokine concentrations compared to women with no infections or BV. Genital infections did not influence plasma cytokine concentrations, suggesting that the compartments were not linked with respect to cytokine responses. Although laboratorydiagnosed STIs were associated with increased risk of HIV infection [hazard ratio, 3.3 (95% confidence interval, 1.5 – 7.2)], clinical symptoms were not. Of the women who became infected, factors predictive of AHI included age, 25 years (OR = 3.2; 1.4 – 7.1), rash (OR = 6.1; 2.4 –15.4), sore throat (OR = 2.7; 1.0 – 7.6), weight loss (OR = 4.4; 1.5 – 13.4), genital ulcers (OR = 8.0; 1.6 – 39.5) and vaginal discharge (OR = 5.4; 1.6 – 18.4). A risk score of 2 correctly predicted AHI in 50.0% of cases. The number of signs and symptoms correlated with higher HIV-1 RNA at diagnosis (r = 0.63; p = 0.001). The 62 acutely infected women were identified at a median of 42 days post-infection (IQR = 34 – 59). Mean CD4 count dropped by 39.6% at 3 months and 46.7% at 6 months post-infection in women with pre-infection measurements. CD4 decline to <350 cells/μL occurred in 31%, 44%, and 55% of women at 1, 2, and 3 years post-infection, respectively, and to <500 cells/μL in 69%, 79%, and 81% at equivalent time-points. Predictors of rapid progression were CD4 count at 3 months post-infection (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.31–3.28; P = .002), setpoint viral load (HR, 3.82; 95% CI, 1.51–9.67; P = .005), and hepatitis B coinfection (HR, 4.54; 95% CI, 1.31–15.69; P = .017). Conversely, presence of any of HLAB*1302, B*27, B*57, B*5801, or B*8101 alleles predicted non–rapid progression (HR, 0.19; 95% CI, .05–.74; P = .016). Discussion/Conclusion: This study showed that syndromic STI diagnosis, which is dependent on clinical signs of vaginal discharge, was poorly predictive of laboratory-diagnosed STIs or BV and missed a significant proportion of women with asymptomatic infections. However, the level of genital inflammation, as measured by cytokine concentrations in CVL, was similar in women with symptomatic and asymptomatic infections and therefore place women at increased risk for HIV infection. While laboratory-diagnosed STIs and the presence of inflammatory cytokines in the genital tract were associated with increased susceptibility to HIV acquisition, vaginal discharge was not. Chlamydial infection was associated with the highest genital cytokine concentrations, followed by gonorrhoea, HSV-2, trichomoniasis, and BV. In regions where HIV is prevalent and STIs are managed syndromically, targeted screening of populations at risk for STIs is critical and urgently needed. Recognition of signs and symptoms of AHI is important for early diagnosis of HIV infection. The proposed algorithm of risk-stratifying individuals for AHI provides a useful clinical tool especially in resource-limited settings where there are limited or no routinely available tests for AHI. However, validation of the algorithm on another cohort is needed to assess its utility further. Point-of-care HIV antigen or viral load testing is needed, to detect asymptomatic, antibody negative cases enabling early interventions and prevention of transmission. This cohort showed high rates of rapid disease progression, with nearly half of these subtype C–infected women progressing to a CD4+ T cell count of below 350 cells/μL within 2 years of infection. Implementing 2013 World Health Organization treatment guidelines (CD4+ T cell counts less than 500cells/μL) would require most individuals to start antiretroviral therapy within 1 year of HIV infection. The economic and health systems planning implicated by these findings need to be explored and addressed to guide policy makers as countries adopt the current WHO guidelines.Item Increased levels of inflammatory cytokines in the female reproductive tract are associated with altered expression of proteases, mucosal barrier proteins, and an influx of HIV-susceptible target cells.(Nature., 2016) Arnold, Kelly B.; Burgener, Adam D.; Birse, Kenzie D. M.; Romas, Laura.; Dunphy, Laura J.; Shahabi, Kamnoosh.; Abou, Max.; Westmacott, Garrett R.; McCorrister, Stuart J.; Kwatampora, Jessie.; Nyanga, Billy.; Kimani, Joshua.; Masson, Lindi.; Liebenberg, Lenine Julie.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.; Lauffenburger, Douglas A.; Kaul, Rupert.; McKinnon, Lyle R.Abstract available in pdf.Item Inflammatory cytokine biomarkers to identify women with asymptomatic sexually transmitted infections and bacterial vaginosis who are at high risk of HIV infection.(BMJ., 2016) Masson, Lindi.; Arnold, Kelly B.; Little, Francesca.; Mlisana, Koleka Patience.; Lewis, David A.; Mkhize, Nonhlanhla.; Gamieldien, Hoyam.; Ngcapu, Sinaye.; Johnson, Leigh.; Lauffenburger, Douglas A.; Abdool Karim, Quarraisha.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Innate antibacterial activity in female genital tract secretions is associated with increased risk of HIV acquisition.(Mary Ann Liebert., 2015) Pellett Madan, Rebecca.; Masson, Lindi.; Tugetman, Jessica.; Werner, Lise.; Grobler, Anna Christina.; Mlisana, Koleka Patience.; Lo, Yungtai.; Che, Denise.; Arnold, Kelly B.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.; Herold, Betsy C.Abstract available in pdf.Item Interleukin-10 Promoter Polymorphisms Influence HIV-1 Susceptibility and Primary HIV-1 Pathogenesis.(The Infectious Diseases Society of America., 2008) Naicker, Dshanta Dyanedi.; Werner, Lise.; Kormuth, Emil.; Passmore, Jo-Ann Shelley.; Mlisana, Koleka Patience.; Abdool Karim, Salim Safurdeen.; Ndung'u, Peter Thumbi.Interleukin (IL)–10 directly inhibits human immunodeficiency virus type 1 (HIV-1) replication, but it may also promote viral persistence by inactivation of effector immune mechanisms. Here, we show in an African cohort that individuals with genotypes associated with high IL-10 production at 2 promoter single-nucleotide polymorphisms ( 1082 and 592) were less likely to become HIV-1 infected but had significantly higher median plasma viral loads during the acute phase ( 3 months after infection). However, as the infection progressed, the association between genotype and median viral load was reversed. Thus, IL-10 may influence HIV-1 susceptibility and pathogenesis, but effects on the latter may differ according to the infection phase.Item Lower concentrations of chemotactic cytokines and soluble innate factors in the lower female genital tract associated with the use of injectable hormonal contraceptive.(Elsevier., 2015) Ngcapu, Sinaye.; Masson, Lindi.; Sibeko, Sengeziwe.; Werner, Lise.; McKinnon, Lyle R.; Mlisana, Koleka Patience.; Shey, Muki Shehu.; Samsunder, Natasha.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Modulation of female genital tract-derived dendritic cell migration and activation in response to inflammatory cytokines and toll-like receptor agonists.(Shey, M.S., Maharaj, N., Archary, D., Ngcapu, S., Garrett, N., Abdool Karim, S.S. and Passmore, J.A.S. 2016. Modulation of female genital tract-derived dendritic cell migration and activation in response to inflammatory cytokines and toll-like receptor agonists. PloS One 11(5), e0155668., 2016) Shey, Muki Shehu.; Maharaj, Niren Ray.; Archary, Derseree.; Ngcapu, Sinaye.; Garrett, Nigel Joel.; Abdool Karim, Salim Safurdeen.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Plasma cytokine levels during acute HIV-1 infection predict HIV disease progression.(Lippincott Williams & Wilkins., 2010) Roberts, Lindi.; Williamson, Carolyn.; Little, Francesca.; Bebell, Lisa M.; Mlisana, Koleka Patience.; Burgers, Wendy A.; Passmore, Jo-Ann Shelley.; van Loggerenberg, Francois.; Walzl, Gerhard.; Djoba Siawaya, Joel Fleury.; Abdool Karim, Salim Safurdeen.; Abdool Karim, Quarraisha.Background: Both T-cell activation during early HIV-1 infection and soluble markers of immune activation during chronic infection are predictive of HIV disease progression. Although the acute phase of HIV infection is associated with increased pro-inflammatory cytokine production, the relationship between cytokine concentrations and HIV pathogenesis is unknown. Objectives: To identify cytokine biomarkers measurable in plasma during acute HIV-1 infection that predict HIV disease progression. Design: Study including 40 South African women who became infected with HIV-1 and were followed longitudinally from the time of infection. Methods: The concentrations of 30 cytokines in plasma from women with acute HIV-1 infection were measured and associations between cytokine levels and both viral load set point 12 months postinfection and time taken for CD4 cell counts to fall below 350 cells/ul were determined using multivariate and Cox proportional hazards regression. Results: We found that the concentrations of five plasma cytokines, IL-12p40, IL-12p70, IFN-y, IL-7 and IL-15 in women with acute infection predicted 66% of the variation in viral load set point 12 months postinfection. IL-12p40, IL-12p70 and IFN-y were significantly associated with lower viral load, whereas IL-7 and IL-15 were associated with higher viral load. Plasma concentrations of IL-12p40 and granulocyte–macrophage colony-stimulating factor during acute infection were associated with maintenance of CD4 cell counts above 350 cells/ul, whereas IL-1a, eotaxin and IL-7 were associated with more rapid CD4 loss. Conclusion: A small panel of plasma cytokines during acute HIV-1 infection was predictive of long-term HIV disease prognosis in this group of South African women.Item Probiotics for vaginal health in South Africa : what is on retailers’ shelves?(BioMed Central., 2017) Happel, Anna-Ursula.; Jaumdally, Shameem Z.; Pidwell, Tanya.; Cornelius, Tracy.; Jaspan, Heather B.; Froissart, Remy.; Barnabas, Shaun L.; Passmore, Jo-Ann Shelley.Abstract available in pdf.Item Randomized cross-sectional study to compare HIV-1 specific antibody and cytokine concentrations in female genital secretions obtained by menstrual cup and cervicovaginal lavage.(Public Library of Science., 2015) Archary, Derseree.; Liebenberg, Lenine Julie.; Werner, Lise.; Tulsi, Sahil.; Majola, Nelisile.; Naicker, Nivashnee.; Dlamini, Sarah Alexandra.; Hope, Thomas J.; Samsunder, Natasha.; Abdool Karim, Salim Safurdeen.; Morris, Lynn.; Passmore, Jo-Ann Shelley.; Garrett, Nigel Joel.Abstract available in pdf.