Increase in endocervical CD4 lymphocytes among women with nonulcerative sexually transmitted diseases.
To assess associations of nonulcerative sexually transmitted diseases (STDs) with human immunodeficiency virus (HIV)-susceptible leukocytes on female genital mucosa, cervicovaginal specimens from 32 HIV-negative STD clinic patients with gonorrhea, chlamydial infection, or trichomoniasis were compared with specimens from 32 clinic patients without these infections. Twenty-eight patients had single infections (15 gonorrhea, 10 chlamydial infection, 3 trichomoniasis), and 4 had dual infections. A saline vaginal wash and saline suspensions of vaginal wall scrapings, ectocervical scrapings, and endocervical brushings were analyzed by flow cytometry. Specimens from the endocervix had the highest proportions of lymphocytes, monocytes, and Langerhans' cells. The median number of endocervical CD4 lymphocytes/10,000 cells was greater among patients with STDs than among those without (476 vs. 245; P < .001). These data suggest that the endocervix may have a particularly important role in heterosexual HIV transmission and that nonulcerative STDs may facilitate HIV transmission by increasing the presence of CD4 lymphocytes at this site.
Levine
W C
WC
Division of Sexually Transmitted Disease Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, and Fulton County Health Department, Atlanta, Georgia 30333, USA.
Pope
V
V
Bhoomkar
A
A
Tambe
P
P
Lewis
J S
JS
Zaidi
A A
AA
Farshy
C E
CE
Mitchell
S
S
Talkington
D F
DF
D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002452:Cell Count; D002584:Cervix Uteri / Q000276:immunology; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D018562:Disease Transmission, Infectious; D005260:Female; D005434:Flow Cytometry; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D006098:Granulocytes / Q000276:immunology; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D018928:Immunity, Mucosal; D007801:Langerhans Cells / Q000276:immunology; D009000:Monocytes / Q000276:immunology; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000032:analysis; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D014247:Trichomonas Vaginitis / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D014621:Vagina / Q000276:immunology
D016692:Receptors, Antigen, T-Cell, gamma-delta