Abstract:
Objective: Although non-ulcerative sexually transmitted diseases (STD) and bacterial
vaginosis are implicated as cofactors in heterosexual HIV-1 transmission, the
mechanisms have not been defined. Recent in vitro data suggest that interleukin (IL)-
10 may increase susceptibility of macrophages to HIV-1 infection. Therefore, we
performed this study to assess whether non-ulcerative STD are associated with
detection of IL-10 in the female genital tract.
Methods: Women with clinical pelvic inflammatory disease with or without
cervicovaginal discharge were recruited from an STD clinic in Nairobi, Kenya.
Endocervical and endometrial specimens were obtained for Neisseria gonorrhoeae
and Chlamydia trachomatis DNA detection, Trichonomas vaginalis culture, and CD4
and CD8 T-cell enumeration. Bacterial vaginosis was diagnosed by Gram stain. IL-10
was detected in endocervical specimens using enzyme-linked immunosorbent assay.
Blood was obtained for HIV-1 serology.
Results: One hundred and seventy-two women were studied. N. gonorrhoeae,
C. trachomatis, bacterial vaginosis, and T. vaginalis were detected in 38 (21%), 17
(9%), 71 (43%), and 22 (12%) women, respectively. Cervical IL-10 was detected
more often in women with N. gonorrhoeae [adjusted odds ratio (AOR), 3.4; 95%
confidence interval (CI), 1.4–8.4], C. trachomatis (AOR, 4.4; 95% CI, 1.2–15.6), and
bacterial vaginosis (AOR, 3.1; 95% CI, 1.4–6.9) than in women without these
infections.
Conclusions: The association of non-ulcerative STD and bacterial vaginosis with
increased frequency of IL-10 detection in endocervical secretions suggests a
potential mechanism through which these infections may alter susceptibility to HIV-
1 infection in women
