Male genital tract inflammation associated with increased numbers of potential human immunodeficiency virus host cells in semen.

In this study we investigated whether elevated levels of the inflammatory mediator granulocyte elastase in seminal plasma were associated with increased numbers of CD4+ T helper/inducer lymphocytes and monocytes/macrophages in semen, the principal host cells of the human immunodeficiency virus (HIV). Semen samples were obtained from 105 men attending an infertility clinic. CD4+ lymphocytes, monocytes/macrophages and cells expressing the common leukocyte antigen (CD45) were identified by monoclonal antibodies (MAb's) in a biotinstreptavidin immunoperoxidase technique. Granulocyte elastase levels in seminal plasma were determined by an enzyme-linked immunosorbent assay. In 17 men, granulocyte elastase levels were higher than 1000 ng/ml seminal plasma, indicating male genital tract inflammation. Compared to men with low/normal granulocyte elastase levels in semen (less than 250 ng/ml), these men showed significantly higher mean numbers of total leukocytes, CD4+ lymphocytes and monocytes/macrophages in semen (P less than 0.001); median cell numbers for the group with high/inflammatory granulocyte elastase levels were increased 38-fold for total leukocytes (19,800,000 versus 520,625 per ejaculate), 19-fold for monocytes/macrophages (2,594,000 versus 134,565), and 6-fold for CD4+ lymphocytes (82,900 versus 14,100). Because of the increased numbers of potential HIV-host cells in inflammatory semen, male genital tract inflammation may be an important cofactor in the sexual transmission of the human immunodeficiency virus.