title: Mucosal Neisseria gonorrhoeae coinfection during HIV acquisition is associated with enhanced systemic HIV-specific CD8 T-cell responses.
abstract: BACKGROUND
  The host immune response against mucosally acquired pathogens may be influenced by the mucosal immune milieu during acquisition. As Neisseria gonorrhoeae can impair dendritic cell and T-cell immune function, we hypothesized that coinfection during HIV acquisition would impair subsequent systemic T-cell responses.
  
  
  METHODS
  Monthly screening for sexually transmitted infections was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8 T-cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.
  
  
  RESULTS
  Thirty-five participants acquired HIV during follow-up, and 16 out of 35 (46%) had a classical sexually transmitted infection at the time of acquisition. N. gonorrhoeae coinfection was present during HIV acquisition in 6 out of 35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8 T-cell responses, using both interferon-gamma gamma and MIP-1 beta as an output. No other genital infections were associated with differences in HIV-specific CD8 T-cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.
  
  
  CONCLUSIONS
  Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8 T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.
authors.affiliation: Department of Medicine, , University of Toronto, Ontario, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sheung
authors.forename: Anu
authors.initials: A
authors.lastname: Rebbapragada
authors.forename: Lucy Y Y
authors.initials: LY
authors.lastname: Shin
authors.forename: Wendy
authors.initials: W
authors.lastname: Dobson-Belaire
authors.forename: Joshua
authors.initials: J
authors.lastname: Kimani
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ngugi
authors.forename: Kelly S
authors.initials: KS
authors.lastname: MacDonald
authors.forename: Job J
authors.initials: JJ
authors.lastname: Bwayo
authors.forename: Stephen
authors.initials: S
authors.lastname: Moses
authors.forename: Scott
authors.initials: S
authors.lastname: Gray-Owen
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul