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Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

(2014) ISME JOURNAL. 8(9). p.1781-1793
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European and Developing Countries Clinical Trials Partnership (project number IP.2007.33070.001)
Abstract
Cervicovaginal microbiota not dominated by lactobacilli may facilitate transmission of HIV and other sexually transmitted infections (STIs), as well as miscarriages, preterm births and sepsis in pregnant women. However, little is known about the exact nature of the microbiological changes that cause these adverse outcomes. In this study, cervical samples of 174 Rwandan female sex workers were analyzed cross-sectionally using a phylogenetic microarray. Furthermore, HIV-1 RNA concentrations were measured in cervicovaginal lavages of 58 HIV-positive women among them. We identified six microbiome clusters, representing a gradient from low semi-quantitative abundance and diversity dominated by Lactobacillus crispatus (cluster R-I, with R denoting ‘Rwanda’) and L. iners (R-II) to intermediate (R-V) and high abundance and diversity (R-III, R-IV and R-VI) dominated by a mixture of anaerobes, including Gardnerella, Atopobium and Prevotella species. Women in cluster R-I were less likely to have HIV (P¼0.03), herpes simplex virus type 2 (HSV-2; Po0.01), and high-risk human papillomavirus (HPV; Po0.01) and had no bacterial STIs (P¼0.15). Statistically significant trends in prevalence of viral STIs were found from low prevalence in cluster R-I, to higher prevalence in clusters R-II and R-V, and highest prevalence in clusters R-III/R-IV/R-VI. Furthermore, only 10% of HIV-positive women in clusters R-I/R-II, compared with 40% in cluster R-V, and 42% in clusters R-III/ R-IV/R-VI had detectable cervicovaginal HIV-1 RNA (Ptrend¼0.03). We conclude that L. crispatusdominated, and to a lesser extent L. iners-dominated, cervicovaginal microbiota are associated with a lower prevalence of HIV/STIs and a lower likelihood of genital HIV-1 RNA shedding.
Keywords
Rwanda, sexually transmitted infections, HIV, cervicovaginal microbiome, bacterial vaginosis, cervicovaginal HIV-1 RNA, TRANSMISSION, INFECTION, DISEASE, IDENTIFICATION, BACTERIAL VAGINOSIS, IMMUNODEFICIENCY-VIRUS TYPE-1, LONGITUDINAL ANALYSIS, NEISSERIA-GONORRHOEAE, VAGINAL MICROBIOTA, GARDNERELLA-VAGINALIS

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Citation

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Chicago
Borgdorff, Hanneke, Evgeni Tsivtsivadze, Rita Verhelst, Massimo Marzorati, Suzanne Jurriaans, Gilles F Ndayisaba, Frank H Schuren, and Janneke HHM van de Wijgert. 2014. “Lactobacillus-dominated Cervicovaginal Microbiota Associated with Reduced HIV/STI Prevalence and Genital HIV Viral Load in African Women.” Isme Journal 8 (9): 1781–1793.
APA
Borgdorff, H., Tsivtsivadze, E., Verhelst, R., Marzorati, M., Jurriaans, S., Ndayisaba, G. F., Schuren, F. H., et al. (2014). Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women. ISME JOURNAL, 8(9), 1781–1793.
Vancouver
1.
Borgdorff H, Tsivtsivadze E, Verhelst R, Marzorati M, Jurriaans S, Ndayisaba GF, et al. Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women. ISME JOURNAL. 2014;8(9):1781–93.
MLA
Borgdorff, Hanneke, Evgeni Tsivtsivadze, Rita Verhelst, et al. “Lactobacillus-dominated Cervicovaginal Microbiota Associated with Reduced HIV/STI Prevalence and Genital HIV Viral Load in African Women.” ISME JOURNAL 8.9 (2014): 1781–1793. Print.
@article{4327685,
  abstract     = {Cervicovaginal microbiota not dominated by lactobacilli may facilitate transmission of HIV and other sexually transmitted infections (STIs), as well as miscarriages, preterm births and sepsis in pregnant women. However, little is known about the exact nature of the microbiological changes that cause these adverse outcomes. In this study, cervical samples of 174 Rwandan female sex workers were analyzed cross-sectionally using a phylogenetic microarray. Furthermore, HIV-1 RNA concentrations were measured in cervicovaginal lavages of 58 HIV-positive women among them. We identified six microbiome clusters, representing a gradient from low semi-quantitative abundance and diversity dominated by Lactobacillus crispatus (cluster R-I, with R denoting {\textquoteleft}Rwanda{\textquoteright}) and L. iners (R-II) to intermediate (R-V) and high abundance and diversity (R-III, R-IV and R-VI) dominated by a mixture of anaerobes, including Gardnerella, Atopobium and Prevotella species. Women in cluster R-I were less likely to have HIV (P{\textonequarter}0.03), herpes simplex virus type 2 (HSV-2; Po0.01), and high-risk human papillomavirus (HPV; Po0.01) and had no bacterial STIs (P{\textonequarter}0.15). Statistically significant trends in prevalence of viral STIs were found from low prevalence in cluster R-I, to higher prevalence in clusters R-II and R-V, and highest prevalence in clusters R-III/R-IV/R-VI. Furthermore, only 10\% of HIV-positive women in clusters R-I/R-II, compared with 40\% in cluster R-V, and 42\% in clusters R-III/ R-IV/R-VI had detectable cervicovaginal HIV-1 RNA (Ptrend{\textonequarter}0.03). We conclude that L. crispatusdominated, and to a lesser extent L. iners-dominated, cervicovaginal microbiota are associated with a lower prevalence of HIV/STIs and a lower likelihood of genital HIV-1 RNA shedding.},
  author       = {Borgdorff, Hanneke and Tsivtsivadze, Evgeni and Verhelst, Rita and Marzorati, Massimo and Jurriaans, Suzanne and Ndayisaba, Gilles F and Schuren, Frank H and van de Wijgert, Janneke HHM},
  issn         = {1751-7362},
  journal      = {ISME JOURNAL},
  language     = {eng},
  number       = {9},
  pages        = {1781--1793},
  title        = {Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women},
  url          = {http://dx.doi.org/10.1038/ismej.2014.26},
  volume       = {8},
  year         = {2014},
}

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