Scopus 2001-2005
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Publication Metadata only Case-control studies on host factors in severe malaria(2001-07-04) Mathieu Nacher; Pratap Singhasivanon; Frédérick Gay; Udomsak Silachamroon; Sornchai Looareesuwan; Faculte de Medecine Pierre et Marie Curie; Mahidol UniversityAlthough molecular biology has illustrated the phenotypic heterogeneity of Plasmodium falciparum, there are still no specific markers of virulence. As parasite virulence is an important determinant of severe malaria, the choice of comparison groups in the study of host factors influencing severity is a delicate issue. Ignoring parasite factors in the selection of controls potentially leads to biased comparisons between a majority of cases with virulent parasites and a majority of controls with non-virulent parasites. This article discusses how to avoid this virulence bias in the absence of specific markers of virulence.Publication Metadata only Thai population data on nine tetrameric STR loci - D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D5S818, D13S317 and D7S820(2001-01-01) Wasun Chantratita; Budsaba Rerkamnuaychoke; Ubonrat Jomsawat; Janpen Thanakitgosate; Tharathip Ruangvithayanon; Porntip Rojanasunan; Mahidol University; Thailand Ministry of Public HealthAllele frequencies for the nine STR loci included in the AmpFlSTR Profiler kit were determined in a Thai population of 100 unrelated individuals. (C) 2001 Elsevier Science Ireland Ltd.Publication Metadata only Fractionation of arsenic in soil by a continuous-flow sequential extraction method(2001-12-24) J. Shiowatana; R. G. McLaren; N. Chanmekha; A. Samphao; Mahidol UniversityBatch sequential extraction techniques for fractionating metals or metalloids in soils are time consuming and subject to several potential errors. The development of a continuous-flow sequential extraction method for soil As is described and assessed, having the benefits of simplicity, rapidity, less risk of contamination, and less vulnerability to changes in extraction conditions compared with traditional batch methods. The validated method was used to fractionate soil As using water, NaHCO3, NaOH, and HCl, followed by digestion of the residue with HNO3 and HF acids. The extracts and digests were analyzed for As by graphite furnace atomic absorption spectrometry. Good recoveries of total soil As (97-115%) were obtained and fractionation data generally comparable with those obtained using conventional batch techniques. Soils from a tin-mining area in Thailand and soils from As-contaminated cattle (Bos taurus) dip sites in Australia were used to test the applicability of the method, and to demonstrate the usefulness of the extractogram obtained. The ability to produce detailed extractograms for As and other elements (Al, Fe, and Ca) enabled an examination of elemental associations in individual fractions. With the exception of As extracted with HCl, the extractograms generally support previous suggestions of the likely forms or associations of As present in the different soil fractions.Publication Metadata only The crystal structures of glutathione S-transferases isozymes 1-3 and 1-4 from Anopheles dirus species B(2001-11-01) Aaron J. Oakley; Thasaneeya Harnnoi; Rungrutai Udomsinprasert; Kanya Jirajaroenrat; Albert J. Ketterman; Matthew C.J. Wilce; University of Western Australia; Mahidol UniversityGlutathione S-transferases (GSTs) are dimeric proteins that play an important role in cellular detoxification. Four GSTs from the mosquito Anopheles dirus species B (Ad), an important malaria vector in South East Asia, are produced by alternate splicing of a single transcription product and were previously shown to have detoxifying activity towards pesticides such as DDT. We have determined the crystal structures for two of these alternatively spliced proteins, AdGST1-3 (complexed with glutathione) and AdGST1-4 (apo form), at 1.75 and 2.45 Å resolution, respectively. These GST isozymes show differences from the related GST from the Australian sheep blowfly Lucilia cuprina; in particular, the presence of a C-terminal helix forming part of the active site. This helix causes the active site of the Anopheles GSTs to be enclosed. The glutathione-binding helix α2 and flanking residues are disordered in the AdGST1-4 (apo) structure, yet ordered in the AdGST1-3 (GSH-bound) structure, suggesting that insect GSTs operate with an induced fit mechanism similar to that found in the plant phi- and human pi-class GSTs. Despite the high overall sequence identities, the active site residues of AdGST1-4 and AdGST1-3 have different conformations.Publication Metadata only evaluation of culture and PRC-based assay for detection of Mycobacterium tuberculosis from sputum collected and stored on filter paper(2001-12-01) Unchalee Tansuphasiri; Benchapron Chinrat; Somsak Rienthong; Mahidol UniversityWe evaluated the use of culture and PCR-based assay for the direct detection of Mycobacterium tuberculosis (MTB) from sputum collected and stored on filter paper at room temperature for 5 days; the results were compared with those of staining and conventional culture of fresh sputum before storage (the 'gold standard'). Out of 231 sputum specimens examined, MTB was recovered from 124 samples by culture before storage. The culture positivity rate was significantly decreased to 70% after 5 days storage. For PCR assay, a fragment of 377 bp of the IS6110 sequence was amplified and detected using three methods : first PCR product combined with agarose gel electrophoresis (AGE); first PCR product with dot blot hybridization (DBH); nested PCR with AGE. Compared with culture, the sensitivity, specificity, and efficiency for first PCR with AGE were 71.8, 100 and 84.9% respectively; PCR with DBH gave results of 89.5, 96.3 and 92.6% respectively; the same values for nested PCR were 96,0, 97.2, and 96.5% respectively. Of these three methods, nested PCR gave excellent sensitivity and specificity with no significant difference (p = 0.727) from conventional culture. The storage of sputum on filter paper and storage at room temperature for 5 days had no apparent effect on the performance of nested PCR. We propose that this collection and storage method be considered for transporting sputum specimens from peripheral health centers or from the field; specimens may be sent by post to a central point for both culture and PCR analysis by trained technicians supervised in accordance with a well-established quality control system.Publication Metadata only Safety and efficacy of meloxicam 7.5 mg in the treatment of osteoarthritis in Thai patients(2001-10-01) Narong Bunyaratavej; Sommart Keorochana; Sahachart Pithkul; Mahidol University; Pramongkutkhlao HospitalA prospective, open trial to evaluate the safety and efficacy of oral meloxicam 7.5 mg once daily over a period of 28 days in Thai patients with osteoarthritis was conducted in 3 major hospitals in Bangkok, Thailand. A total of 137 patients were enrolled and completed the study protocol. The mean age of the patients was 57.6 years and 88 per cent were female. Pain on movement and pain at rest evaluated after treatment by visual analog scale (VAS) were significantly improved with respect to the baseline status (p<0.001). The final efficacy was reported as satisfactory or good in 97 per cent and 94 per cent as determined by patients and physicians respectively. Patient status evaluated at the end of the study reported improvement of their arthritic condition in 84 per cent. Drug tolerability assessed by patients and physicians and was good or satisfactory in 99 per cent and 98 per cent. GI adverse event was reported in 8.8 percent. Other adverse events were itching / rash in 2.0 percent and headache/insomnia in 1.5 per cent of patients. No patients withdrew from the study due to adverse events. No GI bleeding or perforation were observed. No hospitalization was observed during the study. There was no significant change of blood chemistry and hematological profile between pre and post treatment examination. Results from this study suggest that oral meloxicam 7.5 mg for 28 days is a safe and effective treatment regimen with high GI tolerability profile for the treatment of osteoarthritis in Thai patients.Publication Metadata only Clinical use of erythromycin in children with gastrointestinal dysmotility(2001-07-01) Prapun Aanpreung; Chirasri Vajaradul; Mahidol UniversityIntolerant feeding is a common symptom in gastrointestinal disorders which is commonly found in systemic diseases. Prokinetic drugs play a role in management. A low dose of erythromycin has an effect on improvement of antroduodenal motility and gastric emptying in children and adults. The objective of this study was to evaluate the efficacy of intravenous erythromycin in the treatment of GI dysmotility in children. Retrospective studies were performed in the Department of Pediatrics, Siriraj Hospital, Mahidol University between 1996 and 2000 in 22 patients with intolerance of feeding due to GI dysmotility. Their ages ranged from 11 days to 12 years (42.1 ± 48.1 months). The patients were divided into 2 groups: 12 critically ill and 10 non-critically ill patients. Dosages of intravenous erythromycin were 1-3 mg/kg/dose every 6 hours. The result of treatment was evaluated as: good (tolerant feeding), fair (tolerant feeding but needing erythromycin for longer than 1 month) and failed (intolerant feeding). All non-critically ill patients had improved symptoms with 9 ± 4.3 days duration of treatment. In the other group, 8 patients had good results with 10.9 ± 6 days of treatment. Two patients needed the drug for longer than 1 month and the other 2 patients did not respond and died due to severe infection. Low dose intravenous erythromycin had good efficacy in the treatment of intolerant feeding related to GI dysmotility in children.Publication Metadata only HLA alloimmunization in patients receiving multitransfusions of red blodd cells(2001-06-01) Ampaiwan Chuansumrit; Oytip Nathalang; Somporn Wangruangsathit; Phongjan Hathirat; Pimol Chiewsilp; Parttraporn Isarangkura; Phramongkutklao College of Medicine; Pisanulok Provincial Hospital; Mahidol UniversityHLA antibodies were studied in 88 patients with chronic hemolytic anemia who received multitransfusions of red blood cells prepared by conventional (PRC-C), inverted centrifugation (LR-I) and leukocyte filter (LR-F) techniques. Their mean age was 8 years and 4 months with a duration of transfusion of 8 years. The patients were divided into five groups: group 1, receiving PRC-C (n=20); group 2, receiving LR-I (n=33); group 3, receiving LR-F (n=11); group 4, subsequently receiving LR-I and LR-F (n=10); and group 5, receiving PRC-C followed by LR-I and LR-F (n=14). The HLA class I antibodies were found in 30 out of 88 patients (34%). All were against HLA antigens commonly found in the Thai population. The patients receiving PRC-C exhibited HLA antibodies of 65%, which was significantly higher than those of patients receiving LR-I (24%) and LR-F (0%). Consequently, the transfusion reactions of fever, chill, rash and urticaria were also commonly found in patients receiving PRC-C (13.4%), which was significantly higher than patients receiving LR-I (0.4%) and LR-F (0%). The leukocyte filter technique has been shown to be effective in preventing HLA alloimmunization and transfusion reactions but the price is rather high. For the inverted centrifugation technique, only transfusion reactions were effectively prevented and the HLA alloimmunization continued to develop. A more effective and low-cost method for the removal of leukocytes should be investigated for these multitransfusion patients.Publication Metadata only Predictive value of latex agglutination test in serological screening for Toxoplasma gondii(2001-06-01) Yaowalark Sukthana; Thaiyooth Chintana; Waraporn Supatanapong; Chutatip Siripan; Amorn Lekkla; Rachatawan Cheabchalrad; Mahidol UniversityThe predictive value of commercial latex agglutination kit (Toxo-Screen DA, bioMerieux) was assessed for use as screening test for Toxoplasma IgG antibody. The sensivity and specificity were also compared with those of the reference standard Sabin-Feldman dye test. Five hundred serum samples were collected from 200 blood donors and 100 each from pregnant women, kidney recipients and HIV infected persons. Eighty (16.0 %) out of 500 subjects were positive for Toxoplasma IgG antibody by ToxoScreen DA (bioMerieux) compared with 57(11.4%) by Sabin-Feldman dye test. The sensivity and specificity of Toxo-Screen DA (bioMerieux) were 100 % and 94.8 % respectively which were similar to previous reports from the area of high prevalence of Toxoplasma infection. In present study the positive predictive value of Toxo-Screen DA (bioMerieux) was only 71.3%. The latex agglutination test should be considered as a screening test for Toxoplasma antibody, especially by small laboratories in remote area due to its availability, simplicity, sensitivity and specificity. However, because of its moderate positive predictive value, the test should be used with caution in screening immunocompromised patients and pregnant women living in areas with low prevalence of Toxoplasma infection. Since the number of false seropositive cases would be relatively higher than in a highly prevalent area, confirmation by the dye test would be needed.Publication Metadata only Rapid differentiation of five common α-thalassemia genotypes by polymerase chain reaction(2001-01-01) Delia C. Tang; Suthat Fucharoen; Ivan Ding; Griffin P. Rodgers; National Institutes of Health, Bethesda; The Institute of Science and Technology for Research and Development, Mahidol University; National Institute of Diabetes and Digestive and Kidney DiseasesThe α-thalassemias are common genetic disorders that arise from reduced synthesis of the α-globin chains. At present, large-scale carrier screening and clinically valuable antenatal detection programs have not been established for the congenital disorder α-thalassemia (α-thal). We have developed a simple nonradioactive polymerase chain reaction (PCR) approach that can detect and differentiate several common α-globin gene deletional α-thals regardless of the break points. When three primer sets wereused - two gene-specific sets for the α1- and α2-globin genes and one set for the β-actin gene (serving as an internal control) - PCR products from genomic DNA were simultaneously amplified and analyzed after coamplification and gel electrophoresis. The number of α-globin genes present in the subjects was determined by the intensity of α1and α2bands normalized with that of β-actin when using densitometry. Our results demonstrate that five common genotypes of deletional α-thal are differentiated by the ratios of α1/β-actin and α2/β-actin. We also examined the feasibility of coupling this allele-specific amplification to a color-complementary assay. This easy and reproducible PCR assay is suitable for identifying α-thal carriers in screenings of large populations and improving genetic counseling.Publication Metadata only Oral quinine pharmacokinetics and dietary salt intake(2001-05-28) Paul Newton; Andrew Simpson; Sompon Wanwimolruk; Pius Maliakal; Leopoldo Villegas; Daniel Kuypers; Nicholas J. White; Mahidol University; John Radcliffe Hospital; University of Otago; Shoklo Malaria Research Unit; Ministry of HealthObjectives: The objective was to determine whether or not dietary salt intake affects the relative bioavailability of oral quinine. Salt intake has been shown to alter quinidine bioavailability. Methods: The pharmacokinetic properties of oral quinine sulphate (600 mg salt) were investigated in seven healthy Caucasian volunteers, in a randomised, crossover study, on low- and high-salt diets. Plasma quinine concentrations were measured by high-performance liquid chromatography (HPLC) and the 24-h urinary sodium excretion was assayed. Results: Although the 24-h urine sodium excretion was significantly higher when the volunteers were on a high-salt diet, there were no significant differences in quinine AUC0-∞, tmax, and Cmaxafter the two diets. The median (range) quinine elimination half-life was significantly shorter after a high-salt diet [8.5 (4.3-10.2) h] than after a low-salt diet [10.0 (7.6-14.8) h] (P = 0.04). Conclusion: Dietary salt does not affect the relative oral bioavailability of quinine sulphate.Publication Metadata only Bioscience and its impact on developing countries. A view from Thailand(2001-09-11) J. Svasti; Mahidol UniversityPublication Metadata only Women's status, household structure and the utilization of maternal health services in Nepal(2001-03-01) Masaki Matsumura; Bina Gubhaju; Mahidol UniversityPublication Metadata only Intrapulmonary pharmacokinetics of ofloxacin in drug-resistant tuberculosis(2001-05-14) N. Chierakul; D. Klomsawat; S. Chulavatnatol; B. Chindavijak; Mahidol UniversityOBJECTIVE: To determine the lung epithelial lining fluid (ELF) and serum levels of ofloxacin in drug-resistant tuberculosis patients during treatment. DESIGN: Ten drug-resistant tuberculosis patients treated with ofloxacin containing regimens for at least 2 weeks were enrolled in the study. Subjects ingested ofloxacin 10 mg/kg and other anti-tuberculosis agents after overnight fasting. RESULTS: Serum and bronchoalveolar lavage fluid were collected at 4 hours after treatment and assayed by high performance liquid chromatography. The mean concentrations of ofloxacin in serum and ELF were 5.889 ± 1.096 and 16.583 ± 8.697 mg/L, respectively. The mean ratio of ELF-to-serum ofloxacin concentration was 2.825 ± 1.275. CONCLUSION: Ofloxacin can penetrate well into the intra-alveolar fluid of patients treated for drug-resistant tuberculosis. The lung ELF concentrations were consistently higher than the minimal inhibitory concentrations of Mycobacterium tuberculosis as determined in vitro.Publication Metadata only Activation of peroxisome proliferator-activated receptor isoforms and inhibition of prostaglandin H2synthases by ibuprofen, naproxen, and indomethacin(2001-12-15) Maisa S. Jaradat; Buanus Wongsud; Srichan Phornchirasilp; Shamina M. Rangwala; Gamal Shams; Melissa Sutton; Karl J. Romstedt; Daniel J. Noonan; Dennis R. Feller; University of Mississippi; Mahidol University; Ohio State University; Capital University; University of KentuckyA series of nonsteroidal anti-inflammatory drugs (NSAIDs) [S(+)-naproxen, ibuprofen isomers, and indomethacin] were evaluated for their activation of peroxisome proliferator-activated receptor (PPAR) α and γ isoforms in CV-1 cells co-transfected with rat PPAR α and γ, and peroxisome proliferator response element (PPRE)-luciferase reporter gene plasmids, for stimulation of peroxisomal fatty acyl CoA β-oxidase activity in H4IIEC3 cells, and for comparative inhibition of ovine prostaglandin endoperoxide H synthase (PGHS)-1 and PGHS-2 and arachidonic acid-induced human platelet activation. Each drug produced a concentration-dependent activation of the PPAR isoforms and fatty acid β-oxidase activity, inhibition of human arachidonic acid-induced platelet aggregation and serotonin secretion, and inhibition of PGHS-1 and PGHS-2 activities. For PPARα activation in CV-1 and H4IIEC3 cells, and the stimulation of fatty acyl oxidase activity in H4IIEC3 cells, the rank order of stereoselectivity was S(+)- ibuprofen > R(-)-ibuprofen; S(+)-ibuprofen was more potent than indomethacin and naproxen on these parameters. On PPARγ, the rank order was S(+)-naproxen > indomethacin > S(+)-ibuprofen > R(-)-ibuprofen. Each drug inhibited PGHS-1 activity and platelet aggregation with the same rank order of indomethacin > S(+)-ibuprofen > S(+)-naproxen > R(-)-ibuprofen. Notably, the S(+)-isomer of ibuprofen was 32-, 41-, and 96-fold more potent than the R(-)-isomer for the inhibition of PGHS-1 activity, human platelet aggregation, and serotonin secretion, respectively. On PGHS-2, the ibuprofen isomers showed no selectivity, and indomethacin, S(+)-ibuprofen, and S(+)-naproxen were 6-, 27-, and 5-fold more potent as inhibitors of PGHS-1 than PGHS-2 activity. These results demonstrate that the mechanisms of action of NSAIDs on these cell systems are different, and we propose that the pharmacological effects of NSAIDs may be related to both their profile of inhibition of PGHS enzymes and the activation of PPARα and/or PPARγ isoforms. © 2001 Elsevier Science Inc. All rights reserved.Publication Metadata only Pathologic changes in the pericoronal tissues of unerupted third molars(2001-09-01) Sutas Rakprasitkul; Mahidol UniversityObjective: The purpose of this study was to determine whether the incidence of pathologic conditions affecting the pericoronal tissue of unerupted third molars justifies their routine removal. Method and materials: The pericoronal tissue associated with completely unerupted third molars was submitted for histologic examination after surgical tooth removal was performed in 37 males and 55 females, aged 13 to 63 years. The 104 unerupted third molars comprised 68 mandibular third molars (65.38%) and 36 maxillary third molars (34.62%). Results: The incidence of normal tissue of a dental follicle was 41.35%, and the incidence of pathologic tissue was 58.65% (dentigerous cyst, 50.96%; chronic nonspecific inflammatory tissue, 4.81%; odontogenic keratocyst, 1.92%; ameloblastoma, 0.96%). The incidence of pathologic conditions was higher than that of normal conditions in all third molar positions. In younger patients, normal tissue was more commonly found, but in patients older than 20 years, the incidence of pathologic tissue was higher than the incidence of normal tissue. Conclusion: Unerupted third molars should be removed before pathologic changes can occur in their pericoronal tissues. This justifies routine removal of unerupted third molars from patients older than 20 years.Publication Metadata only Acceptability of the female condom among sex workers in Thailand: Results from a prospective study(2001-01-01) Supanee Jivasak-Apimas; Joseph Saba; Verapol Chandeying; Chuanchom Sakondhavat; Orawan Kiriwat; Sungwal Rugpao; Wiwat Rojanapithayakorn; Arnaud L. Fontanet; Mahidol University; UNAIDS; Prince Songkla Hospital; Khon Kaen University; Research Institute for Health Sciences; Thailand Ministry of Public Health; Municipal Health Service of Amsterdam; Axios InternationalBackground: The female condom may provide women with the first female-controlled barrier method that is effective against sexually transmitted diseases, including HIV infection. Goal: This study evaluated the acceptability of the female condom among sex workers in Thailand. Study Design: Data on use and acceptability of the female condom were collected using a structured questionnaire during an 8-week follow-up. Results: Analyses included 148 women who were still in follow-up at week 8. Sex workers used, on average, 2.8 female condoms per week. The overall satisfaction rate with the female condom was 68%, although, among users, 31% had difficulties in device insertion, 37% had pain from the inner ring, and 22% reported itching sensations. The main reason for using the female condom in the future was its perceived safety, and the main reason for not using it would be the client's refusal. Conclusion: Two-thirds of the sex workers were satisfied with the female condom. Difficulties at insertion, discomfort during use, and clients' attitude were potential obstacles to the use of the female condom in the future.Publication Metadata only Molecular phylogenetic position of Schistosoma sinensium in the genus Schistosoma(2001-09-12) T. Agatsuma; M. Iwagami; C. X. Liu; Y. Saitoh; M. Kawanaka; S. Upatham; D. Qui; T. Higuchi; Department of Environmental Health Science; Kochi Medical School; Azabu University; National Institute of Infectious Diseases; Mahidol University; Sichuan Inst. of Parasitic Diseases; University of Fukui Faculty of Medical SciencesThe status of Schistosoma sinensium (samples from Thailand and from Sichuan, China) relative to other species of the genus Schistosoma was investigated using DNA sequences from the mitochondrial cytochrome c oxidase subunit 1 (CO1) gene (partial) and the nuclear ribosomal DNA second internal transcribed spacer 2 (ITS2). Trees inferred from these sequences place S. sinensium as sister to the S. japonicum group and suggest a basal position in the clade utilizing snails of the family Pomatiopsidae. The sequence differences between specimens of S. sinensium from China and Thailand are at least as great as between S. malayensis and S. mekongi. Schistosoma sinensium is probably best regarded as a species complex.Publication Metadata only Database of nine tetrameric STR loci - D3S1358, vWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317 and D7S820 in Thai population(2001-06-01) Budsaba Rerkamnuaychoke; Wasun Chantratita; Ubonrat Jomsawat; Janpen Thanakitgosate; Tharathip Ruangvithayanon; Porntip Rojanasunan; Mahidol University; Regional Medical Science Center, NakhonrachasimaAllele distributions for the nine STR loci included in the AmpFlSTR Profiler Plus kit were evaluated in a Thai population of 300 unrelated individuals. © 2001 Elsevier Science Ireland Ltd. All rights reserved.Publication Metadata only HIV-specific cytotoxic T lymphocytes, HLA-A11, and chemokine-related factors may act synergistically to determine HIV resistance in CCR5 Δ32-negative female sex workers in Chiang Rai, northern Thailand(2001-01-01) Busarawan Sriwanthana; Thomas Hodge; Timothy D. Mastro; Charlene S. Dezzutti; Kyle Bond; Henry A.F. Stephens; Leondios G. Kostrikis; Khanchit Limpakarnjanarat; Nancy L. Young; Shoukat H. Qari; Renu B. Lal; Dasnayanee Chandanayingyong; Janet M. McNicholl; Thailand Ministry of Public Health; Centers for Disease Control and Prevention; HIV/AIDS Collaboration; UCL; Rockefeller University; Mahidol UniversityUnderstanding how highly HIV-exposed individuals remain HIV uninfected may be useful for HIV vaccine design and development of new HIV prevention strategies. To elucidate mechanisms associated with resistance to HIV infection, immunologic and genetic factors were examined in 14 HIV-exposed but persistently seronegative (HEPS) female sex workers from Chiang Rai, northern Thailand and in ethnically matched, HIV-positive (n = 59) and HIV-negative women (n = 59). The HEPS women were identified in a study of commercial sex workers who had an HIV-1 incidence of 20.3 per 100 person-years. A high frequency of HLA-A11 was observed in HEPS women (86%) compared with northern Thai controls (56%). HIV-specific cytotoxic T lymphocyte (CTL) lytic responses were detected in cryopreserved peripheral blood mononuclear cells (PBMCs), using HLA-A-matched subtype E HIV-1 peptides in four of seven (57%) HEPS women, eight of eight HIV-positive women, and zero of nine HIV-negative unexposed controls (p = 0.019 HEPS women vs. HIV-negative controls). CTL lysis levels were low, but responses were detected to peptides from Nef, Pol, Gag, and Env. Nef responses predominated in HEPS women. Compared with controls, HEPS women tended to have higher frequencies of CCR5 promotor 59402GG and SDF-1 3′UTR 801A genotypes known to influence HIV transmission or course of disease. HEPS women also had higher levels of spontaneous RANTES production by PBMCs than other groups. Each of these factors could potentially contribute to HIV resistance. As most HEPS women had one or more of these factors, they may prevent HIV infection synergistically by blocking HIV cell entry, delaying its dissemination, or killing HIV-infected cells.