Levels of vaginal secretory leukocyte protease inhibitor are decreased in women with lower reproductive tract infections

OBJECTIVE: Secretory leukocyte protease inhibitor contributes resistance to primary human immunodeficiency virus infection in the oral cavity. However , the levels of this inhibitor in the genital tract of women with sexually transmitted diseases or vaginitis are not well described. The objective was to determine vaginal inhibitor levels in women with symptomatic and asympt omatic genital infections. STUDY DESIGN: We tested 207 nonpregnant women for Neisseria gonorrhoeae, Tr ichomonas vaginalis, Chlamydia trachomatis, Candida species, and bacterial vaginosis by standard methods. A second group of symptom-free pregnant wome n (N = 231) was also studied. Secretory leukocyte protease inhibitor was me asured by enzyme-linked immunosorbent assay, and results were compared by n onparametric methods. RESULTS: Vaginal levels of secretory leukocyte protease inhibitor in both g roups were significantly lower in women with any sexually transmitted disea se than in those without infection (P < .0001). Patients with bacterial vag inosis and those with bacterial vaginosis with yeast vaginitis also had dec reased levels (P < .025). CONCLUSIONS: Levels of secretory leukocyte protease inhibitor in vaginal fl uid are decreased in women with lower genital tract infection. This may rep resent a common mechanism of increasing susceptibility to infection with hu man immunodeficiency virus.