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Results We found that the majority of cytokines/chemokines were at higher concentrations in semen than blood, both in HIV-infected and uninfected men. There were no significant differences between any cytokines/chemokines in the semen of HIV-infected vs uninfected men. We found that TNFa (p=0.013; r=0.55), G-CSF (p=0.0057; r=0.61), IL-10 (p=0.006; r=0.61) and IFNg (p=0.01; r=0.57) seminal levels were significantly associated with increases in seminal viral load. Furthermore, subsequent to controlling for the effect of plasma viral load in a multivariate regression analysis, we found that both seminal IL-10 and IFNg levels were associated with a significant rise in seminal viral load. Conclusion Taken together, the data demonstrate that the immune milieu of the genital tract differs substantially from blood, with the majority of cytokines/chemokines tested elevated in semen. However, there were no differences in the levels of pro-inflammatory mediators in the semen of HIV-infected and uninfected men, or HIV-infected men on suppressive ART. Thus, even in the absence of HIV infection, the male genital tract appears to maintain a state of inflammation, which may have been the result of undetected and untreated co-infections.

Inflammation in the male genital tract: implications for HIV acquisition and transmission