High levels of tumor necrosis factor-alpha and interleukin-1 beta in bacterial vaginosis may increase susceptibility to human immunodeficiency virus

Bacterial vaginosis (BV) was identified recently as a cofactor that promote s sexual transmission of human immunodeficiency virus (HIV). This study was done to determine if interleukin (IL)-1 beta and tumor necrosis factor (TN F)-alpha could be measured consistently in cervical secretions and if high levels of these cytokines were associated with BV. Secretions were obtained from 209 study subjects; most samples had detectable levels of TNF-alpha ( 84.2%) and IL-1 beta (79.8%). BV was detected in 53 (27.0%) of 196 women. H igh cytokine levels were significantly associated with BV (adjusted odds ra tio [AOR], 4.17; 95% confidence interval [CI], 1.69-10.30), oral contracept ive use (AOR, 2.78; 95% CI, 1.04-7.48), and high leukocyte counts on vagina l smear (AOR, 1.18; 95% CI, 1.03-1.36). Since these cytokines could up-regu late local HIV replication through activation of the long terminal repeat p romoter region, the association of BV with high levels of IL-1 beta or TNF- alpha may partly explain the mechanism by which this risk factor enhances H IV transmission.