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We measured biomarkers of subclinical vaginal inflammation, endogenous antimicrobial activity, and vaginal flora in women with BV and repeated sampling 1 week and 1 month after completion of metronidazole therapy. We also compared this cohort of women with BV to a healthy control cohort without BV. A longitudinal, open label study of 33 women with a Nugent score of 4 or higher was conducted. All women had genital swabs, cervicovaginal lavage (CVL) fluid, and cervicovaginal biopsies obtained at enrollment and received 7 days of metronidazole treatment. Repeat sampling was performed approximately 1 week and 1 month after completion of therapy. Participant's baseline samples were compared to a healthy, racially matched control group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    =13) without BV. The CVL from women with resolved BV (Nugent 0\u20133) had significantly higher anti-HIV activity, secretory leukocyte protease inhibitor (SLPI), and growth-related oncogene alpha (GRO-\u03b1) levels and their ectocervical tissues had significantly more CD8 cells in the epithelium. Women with persistent BV after treatment had significantly higher levels of interleukin-1\u03b2, tumor necrosis factor alpha (TNF-\u03b1), and intercellular adhesion molecule 1 (ICAM-1) in the CVL. At study entry, participants had significantly greater numbers of CCR5\n                    <jats:sup>+<\/jats:sup>\n                    immune cells and a higher CD4\/CD8 ratio in ectocervical tissues prior to metronidazole treatment, compared to a racially matched cohort of women with a Nugent score of 0\u20133. These data indicate that BV is associated with changes in select soluble immune mediators, an increase in HIV target cells, and a reduction in endogenous antimicrobial activity, which may contribute to the increased risk of HIV acquisition.\n                  <\/jats:p>","DOI":"10.1089\/aid.2015.0006","type":"journal-article","created":{"date-parts":[[2015,7,23]],"date-time":"2015-07-23T15:12:31Z","timestamp":1437664351000},"page":"1139-1152","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":80,"title":["Bacterial Vaginosis and Subclinical Markers of Genital Tract Inflammation and Mucosal Immunity"],"prefix":"10.1177","volume":"31","author":[{"given":"Andrea Ries","family":"Thurman","sequence":"first","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kimble","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy","family":"Herold","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro M.M.","family":"Mesquita","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raina N.","family":"Fichorova","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Y.","family":"Dawood","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titilayo","family":"Fashemi","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelima","family":"Chandra","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Rabe","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina D.","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Anderson","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Doncel","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School"},{"name":"Eastern Virginia Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,11,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318074e565"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000247627.84791.91"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.013904"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.006"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/503780"},{"key":"e_1_3_3_7_2","unstructured":"UNAIDS WHO: 09 AIDS Epidemic Update. 2009; http:\/\/data.unaids.org\/pub\/Report\/2009\/JC1700_Epi_Update_2009_en.pdf Accessed July15 2010."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199904010-00009"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199509000-00017"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)01063-5"},{"issue":"1","key":"e_1_3_3_11_2","first-page":"S17","article-title":"The vaginal microbial ecosystem and resistance to HIV","volume":"14","author":"Hillier SL","year":"1998","unstructured":"Hillier SL: The vaginal microbial ecosystem and resistance to HIV. 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