Comparison of Nugent Scores and T-cell Markers Within the Female Genital Tract [3J]. (May 2018)

• Record Type: Journal Article
• Authors: Blackwell, Conner O.; Haddad, Lisa; Pollak, Rebecca M.
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533468.47675.1d
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Bacterial Vaginosis (BV) has been shown to increase a woman's susceptibility to infections including HIV, but this connection is poorly understood. Although BV is commonly asymptomatic, it can be diagnosed with Nugent scoring. A numerical score 0-10 is assigned to Gram-stained vaginal swabs based on the presence of Gram positive rods, Gram negative rods, and Gram indeterminate curved rods. This study evaluated the association between Nugent score with immune cell phenotypic markers in the female genital tract. METHODS: HIV-uninfected normally cycling women were recruited into a prospective contraceptive study. Vaginal swabs and cervicovaginal lavage (CVL) samples were obtained at weeks 0, 2, 14, and 16. Vaginal swabs were scored and separated into 3 categories according to established Nugent score criteria: "No BV", "Altered", and "BV". Leukocytes were isolated from CVL samples and measured using multi-color flow cytometry. Proportions of phenotypic markers on CD4 and CD8 cells were compared to Nugent category using an ordinal mixed regression model with random effect for repeated measures, adjusting for age, race, contraceptive use, and presence of sexually transmitted diseases. RESULTS: Among 61 participants, there were 199 total visits with the following Nugent categorizations: 47% "No BV", 8% "Altered", and 45% "BV". Nugent category was significantly associated with increased proportion of CCR7+ CD4 cells, central memory CD4 cells, and central memory CD8 cells. CONCLUSION: BV was shown to alter the local immune environment by increasing the central memory and trafficking capacity of T cells. These results help elucidate the relationship between BV and susceptibility to infection.