High Levels of Tumor Necrosis Factor—α and Interleukin-1β in Bacterial Vaginosis May Increase Susceptibility to Human Immunodeficiency Virus

Bacterial vaginosis (BV) was identified recently as a cofactor that promotes sexual transmission of human immunodeficiency virus (HIV). This study was done to determine if interleukin (IL)—1β and tumor necrosis factor (TNF)—α 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-α (84.2%) and IL-1β (79.8%). BV was detected in 53 (27.0%) of 196 women. High cytokine levels were significantly associated with BV (adjusted odds ratio [AOR], 4.17; 95% confidence interval [CI], 1.69–10.30), oral contraceptive use (AOR, 2.78; 95% CI, 1.04–7.48), and high leukocyte counts on vaginal smear (AOR, 1.18; 95% CI, 1.03–1.36). Since these cytokines could up-regulate local HIV replication through activation of the long terminal repeat promoter region, the association of BV with high levels of IL-1β or TNF-α may partly explain the mechanism by which this risk factor enhances HIV transmission.