Chlamydia trachomatis Enhances HIV Infection of Non-Activated PBMCs

Sexual contact is the most common route of HIV transmission, and the concurrent presence of sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (gonococcus, GC) is known to increase the HIV risk. Antibiotic treatment decreases the incidence of STIs but not HIV. CT and GC activate Toll-like receptors (TLRs) 2 and 4, which act as sensors of microbial infection are critical for initiating immune responses to control infection. We have previously shown that GC enhances HIV infection of primary resting CD4+ T cells through activation of TLR2 but not TLR4. In this study, we determined the effect of live and fixed CT and different species of lactobacilli including L. jensenii and L. reuteri on HIV infection of freshly isolated PBMCs. We found that pretreatment of freshly isolated PBMCs with fresh or fixed CT, but not lactobacilli, promoted HIV infection of freshly isolated CD4+ T cells. Together with our previous reports, we concluded that STIs such as CT and GC but not commensal bacteria like lactobacilli enhanced HIV infection, possibly through immune activation. Importantly, the enhancement effect of fixed CT on HIV infection may explain the failure of antibiotic treatments to reduce the HIV incidence. Combined strategies to inhibit STI growth and STI-mediated mucosal immune activation should be considered for HIV prevention in the settings of STIs.