Similarities in the Markers of Inflammation Between Men With Syphilis and Women With Increased Risk of HIV Acquisition

TO THE EDITOR—We appreciated the recent study by Masson et al that utilized multiplex bead-based enzyme-linked immunosorbent assays (MBB-ELISAs) to associate human immunodeficiency virus (HIV) seroconversionwith raisedgenital inflammatory cytokines from samples from cervicovaginal lavages from KwaZuluNatal, South Africa [1]. The authors found that several cytokines, including macrophage inflammatory protein 1B, macrophage inflammatory protein 1A, interferon gamma-induced protein 10, and interleukin 8 levels, were elevated in HIV seroconverters compared with nonconverters. We conducted a pilot study using MBB-ELISAs to simultaneously screen for 63 cytokines in sera samples collected from patients with and without syphilis in Lima, Peru. Interestingly our study found elevated levels of similar chemotactic, inflammatory, and hematopoietic cytokines to the ones seen in the study by Masson et al. We found 16 cytokines that were increased (P < .05) in 5 HIV–antibody negative, syphilis-infected (rapid plasma reagin [RPR]≥ 1:32, treponema pallidum particle agglutination assay [TPPA]positive) participants (average age: 32 ± 8.8 years) and 5 HIV–antibody negative, syphilis-negative (RPR non-reactive, TPPA-negative) participants (average age: 35.6 ± 7.9 years). Of those 16 cytokines, 11 were not previously described in the literature as being syphilis associated: interleukin 7 (P = .01), vascular endothelial growth factor D (P = .01), macrophage inflammatory protein 1B (P = .01), interferon gamma-induced protein 10 (P = .02), interleukin 12 active heterodimer (P = .02), leptin (P = .02), monocyte-specific chemokine 3 (P = .02), nerve growth factor (P = .03), eotaxin (P = .04), granulocyte macrophage colony-stimulating factor (P = .04), and platelet-derived growth factor (P = .04) [2–10]. We found increased median fluorescence intensity (MFI) values for all of the 16 cytokines in