Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors

作者：Chehoud Christel; Stieh Daniel J; Bailey Aubrey G; Laughlin Alice L; Allen Shannon A; McCotter Kerrie L; Sherrill Mix Scott A; Hope Thomas J; Bushman Frederic D^*

来源：AIDS, 2017, 31(7): 895-904.

DOI：10.1097/QAD.0000000000001421

• bacterial vaginosis
• cervical mucus
• cervicovaginal mucus
• lentivirus
• microbiome
• transmission

Objective: We sought to investigate the effects of HIV infection on the vaginal microbiota and associations with treatment and demographic factors. We thus compared vaginal microbiome samples from HIV-infected (HIV+) and HIV-uninfected (HIV-) women collected at two Chicago area hospitals.
Design: We studied vaginal microbiome samples from 178 women analyzed longitudinally (n = 324 samples) and collected extensive data on clinical status and demographic factors.
Methods: We used 16S rRNA gene sequencing to characterize the bacterial lineages present, then UniFrac, Shannon diversity, and other measures to compare community structure with sample metadata.
Results: Differences in microbiota measures were modest in the comparison of (HIV+) and HIV- samples, in contrast to several previous studies, consistent with effective antiretroviral therapy. Proportions of healthy Lactobacillus species were not higher in HIV- patients overall, but were significantly higher when analyzed within each hospital in isolation. Rates of bacterial vaginosis were higher among African-American women and HIV+ women. Bacterial vaginosis was associated with higher frequency of HIV+. Unexpectedly, African-American women were more likely to switch bacterial vaginosis status between sampling times; switching was not associated with HIV+ status.
Conclusion: The influence of HIV infection on the vaginal microbiome was modest for this cohort of well suppressed urban American women, consistent with effective antiretroviral therapy. HIV+ was found to be associated with bacterial vaginosis. Although bacterial vaginosis has previously been associated with HIV transmission, most of the women studied here became HIV+ many years before our test for bacterial vaginosis, thus implicating additional mechanisms linking HIV infection and bacterial vaginosis.

• 出版日期2017-4-24
• 单位西北大学