OBJECTIVE: To evaluate whether resistance to HIV-1 infection in a subset of highly exposed sex workers correlates with resistance at the cellular level.
DESIGN: In vitro evaluation of susceptibility to infection by Kenyan HIV-1 isolates and cellular production of potential mediators of resistance.
SETTING: Samples were collected in a primary care clinic in Nairobi.
PATIENTS: Thirteen individuals from a cohort of sex workers with a similar risk of acquiring HIV infection and six unexposed controls.
INTERVENTIONS: Subjects were provided with appropriate primary care and counselling on the prevention of sexually transmitted diseases.
RESULTS: No inherent cellular resistance to infection was identified. CD8+cells from a subset of subjects strongly inhibited viral replication.
CONCLUSIONS: Lack of infection in this cohort was not attributable to factors inherent to CD4+cells. Resistance to HIV infection is likely to be multifactorial, and products of CD8+cells and unique features of mucosal sites probably contribute to this state.