Presence of hepatitis C virus (HCV) RNA in the genital tracts of HCV/HIV-1-coinfected women

Background. Hepatitis C virus (HCV) - infected women - in particular, those coinfected with human immunodeficiency virus type 1 (HIV-1) - can transmit infection to their children and sex partners. Methods. The present study was conducted to analyze the presence of HCV RNA in cervicovaginal lavage (CVL) fluid from 71 women (58 HCV/HIV- 1 - coinfected women and 13 HCV-infected, HIV-1-uninfected women) enrolled in the Women's Interagency HIV Study. Results. HCV RNA was detected ( by a commercial polymerase chain reaction assay) in CVL fluid from 18 (29%) of the HIV-1 -infected women and from none of the HIV-1-uninfected women (P < .05). Multivariate analysis revealed that risk factors for the presence of HCV RNA in CVL fluid were HCV viremia ( odds ratio [OR], 16.81; P = .02) and HIV- 1 RNA in CVL fluid ( OR, 19.87; P = .02). This observation suggests local interactions between HIV- 1 and HCV in the genital tract compartment. There was no correlation between HCV RNA in CVL fluid and CD4, CD8, or CD3 cell counts, HIV- 1 RNA viremia, the number of leukocytes in CVL fluid, or HIV- 1 therapy. Furthermore, in 3 of 5 analyzed patients who had a detectable CVL HCV RNA load, we found viral variants differing in the 5' untranslated region that were present neither in plasma nor in peripheral-blood mononuclear cells. Conclusions. Our observations point to the importance of the genital tract compartment, in which local HCV replication could be facilitated by local HIV- 1 replication.