Abstract
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.
Original language | English (US) |
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Pages (from-to) | 895-904 |
Number of pages | 10 |
Journal | AIDS |
Volume | 31 |
Issue number | 7 |
DOIs | |
State | Published - Apr 24 2017 |
Funding
We are grateful to members of the Hope and Bushman laboratories for help and suggestions. We thank Laurie Zimmerman for her assistance with the figures. This work was supported by R01 AI 052845 to F.D.B., the Penn Center for AIDS Research (P30 AI 045008), the PennCHOP Microbiome Program, P01 AI082971 to A.L.F. and T.J.H., R33 AI094584 to T.J.H., and OPP1031734 from the Bill and Melinda Gates foundation (BMFG) to T.J.H. IRB approval numbers were STU00041328 and STU00025456. C.C. and S.A.S.-M. were supported by T32 AI007632.
Keywords
- Bacterial vaginosis
- Cervical mucus
- Cervicovaginal mucus
- Lentivirus
- Microbiome
- Transmission
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases