FIGURE 1.

Impact of Neisseria gonorrhoeae infection on HIV production and shedding in an already HIV infected person. The presence of the gonococci within the urogenital tract results in an exuberant neutrophil response that is characterized by increased presence of pro-inflammatory cytokines and chemokines. This results in the recruitment of infected CD4 T-cells to the area of gonococcal infection, leading to activation of the latent HIV and release of virions to the genital microenvironment. This event could also result in infection of HIV-uninfected but gonococcal-activated CD4 T-cells and further propagation of the virus within the patient. Macrophage and dendritic cells (DCs) may also take up the virus to be presented to CD4 T-cells in distal lymphoid organs, increasing the efficiency of CD4 T cell infection and causing further propagation of infection, ultimately leading to destruction of secondary lymphoid organs. Following gonococcus-induced disruption of the epithelial barrier, either directly by the bacterium or through the inflammatory milieu, the cell free HIV particles may be released freely into the genital lumen to increase infectious potential of this HIV infected individual.