HIV-1 is known to play a critical role in the pathogenesis of AIDS-associated Kaposi's sarcoma (KS). However, it remains controversial whether KS cells are target cells for HIV infection. The aim of this study was to investigate the expression of chemokine receptors in KS cell cultures and to determine whether these cells can be infected by HIV-1.KS-derived cells and KS-Y1 cells were investigated using RT-PCR for the expression of CD4, CCR3, CCR5, CCR8 and CXCR4 mRNA. HIV infectivity of these cells was determined by p24 antigen and HIV-1 RNA production, as well as by HIV-1 DNA integration.With the exception of CCR8 which is expressed by KS-derived spindle cell cultures but not by KS-Y1 cells, unstimulated KS cells express no significant levels of CD4, CCR3, CCR5 or CXCR4 mRNA. HIV infectivity assays showed that KS cells were unpermissive to HTLVIIIB and JRFL strains. Although the expression of CXCR4 mRNA could be upregulated by interleukin-1beta, stimulation of KS cells by this cytokine did not allow infection by HIV-1.This shows that KS cells exhibit a chemokine receptor repertoire that does not allow infection by HIV-1. Other cell types making up KS lesions, such as inflammatory cells, are likely to represent the source of HIV-1 products cooperating to promote KS development and progression.
Today, in developed countries, many HIV-infected people remain in good health thanks to antiviral medication. A growing number of them want to have children. Medical possibilities for preventing contamination of the partners of seropositive men, through assisted reproduction, and of children thanks to antiviral medicines during pregnancy, are summarized. These changes result in ethical considerations which lead the authors to question the conventional systematic medical advise against pregnancy and has encouraged them to assist reproduction for a number of these couples. Today, the balance between the importance of the message of prevention and the benefit for patients of being assisted in their desire for a child has tilted towards medical intervention. It would seem legitimate today to intervene in the most favourable situations rather than see these couples take the risk of spontaneous conception outside health care structures. This implies the need to adapt medical structures (separate laboratory, appropriate procedure, precise protocols). This approach, which is coherent from the scientific point of view, respects both the autonomy of people carrying HIV as well as the essential interests of the child, in being born uninfected, and also has the enormous advantage of allowing access to parenthood without destroying the consistency of the message of prevention of sexual contamination.
To retrospectively evaluate factors influencing human cytomegalovirus serologic status of couples consulting our fertility clinic.Human cytomegalovirus individual serologic status of 3,227 women and 2,565 men was studied according to age, serologic status of the sexual partner, and presence of children in the family at entry in the clinic. Among 1,906 initially seronegative individuals, human cytomegalovirus seroconversions during follow-up were recorded and correlated to age, serologic status of the sexual partner, and presence of children aged younger than 3 years in the family.Human cytomegalovirus status at entry in the fertility clinic depended on age, but women were more frequently seropositive (54%) than men (43%), although they were younger (mean age 33 years for women and 37 years for men). The probability of seroconversion of women and men was significantly associated with the presence of children aged younger than 3 years; 35 of 217 women (16%) and 17 of 130 men (13%) living with children aged younger than 3 years seroconverted compared with 37 of 1,066 women (3.4%) and 16 of 493 men (3.2%) without children. Moreover, women's seroconversion was significantly associated with the seropositivity of the sex partner; 13 of 96 (13.5%) women with a cytomegalovirus seropositive partner seroconverted compared with 33 of 452 (7.3%) of those without such a partner.Our results suggest that human cytomegalovirus is sexually transmitted among couples in our fertility clinic. Safe sex practices should be included in hygiene precaution advice given to pregnant women to avoid human cytomegalovirus contamination.II.
