Immune Responses to HIV in the Female Reproductive Tract, Immunologic Parallels with the Gastrointestinal Tract, and Research Implications


  • Barbara L. Shacklett,

    1. Department of Medical Microbiology and Immunology, and Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, University of California, Davis, CA, USA
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  • Ruth M. Greenblatt

    1. Departments of Clinical Pharmacy, Medicine and Epidemiology/Biostatistics, Schools of Pharmacy and Medicine, University of California, San Francisco, CA, USA
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Barbara L. Shacklett, PhD, Associate Professor, Department of Medical Microbiology and Immunology, 3146 Tupper Hall, 1 Shields Avenue, Davis, CA 95616, USA.


Citation Shacklett BL, Greenblatt RM. Immune responses to HIV in the female reproductive tract, immunologic parallels with the gastrointestinal tract, and research implications. Am J Reprod Immunol 2011; 65: 230–241

The female reproductive tract is a major site of mucosa-associated lymphoid tissue and susceptibility to HIV infection, yet the tissue site(s) of infection and the impact of HIV infection on this important mucosal tissue remain poorly understood. CD4+ T cells and other cell types expressing the major coreceptors for HIV, CCR5, and CXCR4 are abundant in both the lower reproductive tract (endocervix and vagina) and the upper tract (endocervix and uterus) and are highly susceptible to infection. Antiviral defenses in the female reproductive tract are mediated by a variety of soluble factors and by mucosal effector cells that differ phenotypically from their counterparts in blood. The immunologic characteristics of the female reproductive tract parallel those of the gut, where major HIV-related immunologic injury occurs. The susceptibility of the female reproductive tract to HIV infection and immunopathogenesis suggests important new avenues for further research.