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Title: LEVELS OF PRO-INFLAMMATORY CYTOKINES IN THE CERVICOVAGINAL SECRETIONS AMONG HIV POSITIVE WOMEN WITH OR WITHOUT OTHER SEXUALLY TRANSMITTED DISEASES
Authors: Iibrahim, Ali
Advisors: Dr. Yohannes Mengistu
Keywords: Pro-inflammatory cytokines
Viral load
HIV
Cervicovaginal lavage fluid
Sexually transmitted disease
IL-8
TNF-a
Copyright: 2003
Date Added: 17-Apr-2008
Publisher: Addis Ababa University
Abstract: Pro-inflammatory cytokines may stimulate local replication and spread of HIV. To determine the association between cytokines ,viral shedding in vaginal secretions and other sexually transmitted infections ,the level of pro-inflammatory cytokines(TNF-a and IL-8) and viral load in CVL fluids were determined. Cervicovaginal lavag fluid samples were collected from 80 consecutive women complaining active sexually transmitted infections in Tekle-Haymanot Health Center, Addis Ababa. Sixty-one (76%) were found HIV infected and 19 (24%) were seronegative. STDs were identified from 49 of the 61(80%) HIV infected women and 68 (85 %) of the total study subjects. CVL was assayed for tumor necrosis factor- (TNF- ) , IL-8 ,and viral load. Detectable level of TNF- and IL-8 were found in all samples. TNF- ranged between 9.8 and 397 pg/ml with a median 136 pg/ml. Interleukin-8 levels ranged from 28.5 to 137 pg/ml with median 67.47 pg/ml. Viral load was detectable in CVL fluids from 37(61%) and undetectable in 24 (39%) of HIV positive women. Higher levels of TNF- were found in women with STD when compared with STD negative women, a median 144 pg/ml and 93.6 pg/ml respectively ,although the difference was not statistically significant (p>0.05).Viral load in STIs positive women were also found to be higher than STIs negative women CVL fluids ,the difference was found statistically significant (p< 0.05). In CVL fluids with detectable viral load, TNF- levels were found significantly higher than did undetectable viral load (p < 0.05). TNF- value was also found positively correlated with viral load (p<0.01 ,r = 0.338). Higher level of IL-8 was detected in HIV negative women than HIV positive women, the difference was found statistically significant (p < 0.05). IL-8 level was also found elevated in STIs positive women not infected with HIV than HIV positive women co-infected with STIs (p < 0.05). However, statistically significant difference was not found in CVL IL-8 levels between STDs positive and negative groups as well as in CVL fluids with detectable and undetectable viral load. Viral shedding in cervicovaginal fluid of HIV infected viii women was also significantly associated with co-infection with other sexually transmitted infections (p < 0.01). From this result ,it is possible to infer that higher levels of these proinflammatory cytokines in CVL fluids of HIV positive and negative women co-infected with other STIs likely influence local replication and shedding of HIV in female genital tract and may also have impact on acquisition and transmission of the virus. Female genital secretions is the main vehicle for sexual transmission of HIV virus ,thus implementation of effective STIs prevention and control programs are important to reduce the risk of HIV infection.
Description: A thesis submitted to School of Graduate Studies of Addis Ababa University in partial fulfillment of the requirements for the degree of Master of Science in Medical Microbiology. Department of Microbiology , Immunology ,and Prasitology , Faculty of Medicine.
URI: http://hdl.handle.net/123456789/569
Appears in:Thesis - Medical Microbiology

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