Bacterial vaginosis in HIV-infected women induces reversible alterations in the cervical immune environment.
BACKGROUND
Bacterial vaginosis (BV) has been associated with increased HIV cervicovaginal shedding. We hypothesized that this might relate to BV-associated increases in mucosal activated CD4 T cells, which could enhance local HIV replication.


METHODS
Vaginal flora, cytokine/chemokine levels, and mucosal immune cell populations collected by cervical cytobrush were analyzed in 15 HIV-infected Kenyan female sex workers, before and after BV therapy with oral metronidazole.


RESULTS
Therapy reduced the Nugent score in all but 1 participant, and BV elimination was associated with reduced genital levels of interleukin 1beta(IL1beta), interleukin 8 (IL-8), and Regulated Upon Activation Normal T-cell Expressed and Secreted (RANTES). In addition, BV elimination reduced the total number of cervical CD4 T cells, including those expressing the HIV coreceptor CCR5 and the activation marker CD69.


CONCLUSIONS
BV induces significant and reversible alterations in cervical immune cell populations and local inflammatory cytokines that would be expected to enhance local HIV replication.
Rebbapragada
Anuradha
A
Clinical Science Division, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Howe
Kathryn
K
Wachihi
Charles
C
Pettengell
Christopher
C
Sunderji
Sherzana
S
Huibner
Sanja
S
Ball
T Blake
TB
Plummer
Francis A
FA
Jaoko
Walter
W
Kaul
Rupert
R
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000166:cytology / Q000276:immunology*; D018946:Chemokine CCL5 / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008795:Metronidazole / Q000627:therapeutic use; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D017201:Virus Shedding / Q000187:drug effects
D000900:Anti-Bacterial Agents; D018946:Chemokine CCL5; D053583:Interleukin-1beta; D016209:Interleukin-8; D008795:Metronidazole