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Juliana NCA, Deb S, Juma MH, Poort L, Budding AE, Mbarouk A, Ali SM, Ouburg S, Morré SA, Sazawal S, Ambrosino E. The Vaginal Microbiota Composition and Genital Infections during and after Pregnancy among Women in Pemba Island, Tanzania. Microorganisms 2022; 10:microorganisms10030509. [PMID: 35336085 PMCID: PMC8951098 DOI: 10.3390/microorganisms10030509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/03/2022] [Accepted: 02/21/2022] [Indexed: 01/25/2023] Open
Abstract
We investigated the vaginal microbiota (VMB) composition, prevalence of genital pathogens and their association among pregnant and post-delivery women in Pemba Island, Tanzania. Vaginal swabs were collected from 90 women, at two time points during pregnancy (<20 weeks of gestational age [GA] and ≥20 weeks GA) and once after delivery, when possible. IS-pro assay was used for VMB characterization. Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and human papillomavirus (HPV) were detected by qPCRs. VMB were mostly Lactobacillus dominant during pregnancy and non-Lactobacillus dominant post-delivery. A significant decrease in VMB richness was observed during pregnancy among paired and unpaired samples. Shannon diversity was significantly lower during pregnancy than post-delivery among unpaired samples. Klebsiella species and Streptococcus anginosus were the most commonly identified pathobionts at all timepoints. A high abundance of pathobionts was mostly seen in women with non-Lactobacillus dominant VMB. At ≥20 weeks GA timepoint during pregnancy, 63.0% of the women carrying one or more genital pathogen (either HPV, CT, TV, or MG) had L. iners dominant VMB. NG was not detected pre-delivery. This study contributes evidence on VMB composition, its changes during pregnancy and post-delivery, and their association with pathobionts and genital pathogens.
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Affiliation(s)
- Naomi C. A. Juliana
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW (School for Oncology & Reproduction), Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6200 Maastricht, The Netherlands; (N.C.A.J.); (S.A.M.)
| | - Saikat Deb
- Public Health Laboratory—Ivo de Carneri, Chake Chake 74201, Pemba Island, Tanzania; (S.D.); (M.H.J.); (A.M.); (S.M.A.)
- Centre for Public Health Kinetics, New Delhi 110024, India;
| | - Mohamed H. Juma
- Public Health Laboratory—Ivo de Carneri, Chake Chake 74201, Pemba Island, Tanzania; (S.D.); (M.H.J.); (A.M.); (S.M.A.)
| | - Linda Poort
- inBiome, 1098 Amsterdam, The Netherlands; (L.P.); (A.E.B.)
| | | | - Abdalla Mbarouk
- Public Health Laboratory—Ivo de Carneri, Chake Chake 74201, Pemba Island, Tanzania; (S.D.); (M.H.J.); (A.M.); (S.M.A.)
| | - Said M. Ali
- Public Health Laboratory—Ivo de Carneri, Chake Chake 74201, Pemba Island, Tanzania; (S.D.); (M.H.J.); (A.M.); (S.M.A.)
| | - Sander Ouburg
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, Amsterdam UMC, Location AMC, 1105 Amsterdam, The Netherlands;
| | - Servaas A. Morré
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW (School for Oncology & Reproduction), Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6200 Maastricht, The Netherlands; (N.C.A.J.); (S.A.M.)
| | - Sunil Sazawal
- Centre for Public Health Kinetics, New Delhi 110024, India;
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW (School for Oncology & Reproduction), Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6200 Maastricht, The Netherlands; (N.C.A.J.); (S.A.M.)
- Correspondence: ; Tel.: +31-04-3388-4081
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Comparative Effectiveness of Treatments for Bacterial Vaginosis: A Network Meta-Analysis. Antibiotics (Basel) 2021; 10:antibiotics10080978. [PMID: 34439028 PMCID: PMC8388924 DOI: 10.3390/antibiotics10080978] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/28/2021] [Accepted: 08/09/2021] [Indexed: 11/17/2022] Open
Abstract
Bacterial vaginosis (BV) is a common vaginal dysbiosis in women of reproductive age. However, the cure rate for BV varies considerably and many women experience a relapse after the initial treatment. The present meta-analysis aimed to evaluate the clinical cure rates (CCRs) in randomized controlled trials (RCTs) through different therapies and administration routes. This meta-analysis included a final set of 25 eligible studies with a total of 57 RCTs and compared the effectiveness of BV treatments among non-pregnant and pregnant women. The initial range of CCRs varied greatly from 46.75% to 96.20% and the final pooled CCR was 75.5% (CI: 69.4-80.8) using the random model. The heterogeneity indices were Q = 418.91, I2 = 94.27%, and τ = 0.7498 (p < 0.0001). No publication bias was observed according to Funnel plot symmetry and Egger's linear regression test (p = 0.1097). To evaluate different variables, sub-group analysis, meta-regressions, and network meta-analysis were also realized. The highest P-scores in CCR were obtained by: (1) a combined therapy with local probiotic treatment and application of antibiotics by both administration route (oral clindamycin and local 5-nitroimidazole; P-score = 0.92); (2) a combined therapy with oral administration of 5-nitroimidazole and probiotic treatment (P-score = 0.82); (3) and a combined therapy with local administration of 5-nitroimidazole and oral probiotic treatment (P-score = 0.68). A clear-cut decision of the best BV treatment was not possible due to the heterogeneity of outcomes reported in the trials, indicating the necessity for a better characterization of RCTs. Finally, combined therapies suggested the reduction of the optimal concentration of antibiotics, and double phase treatments of antibiotics indicated an increment of CCRs in BV.
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Munoz A, Hayward MR, Bloom SM, Rocafort M, Ngcapu S, Mafunda NA, Xu J, Xulu N, Dong M, Dong KL, Ismail N, Ndung’u T, Ghebremichael MS, Kwon DS. Modeling the temporal dynamics of cervicovaginal microbiota identifies targets that may promote reproductive health. MICROBIOME 2021; 9:163. [PMID: 34311774 PMCID: PMC8314590 DOI: 10.1186/s40168-021-01096-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/18/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Cervicovaginal bacterial communities composed of diverse anaerobes with low Lactobacillus abundance are associated with poor reproductive outcomes such as preterm birth, infertility, cervicitis, and risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Women in sub-Saharan Africa have a higher prevalence of these high-risk bacterial communities when compared to Western populations. However, the transition of cervicovaginal communities between high- and low-risk community states over time is not well described in African populations. RESULTS We profiled the bacterial composition of 316 cervicovaginal swabs collected at 3-month intervals from 88 healthy young Black South African women with a median follow-up of 9 months per participant and developed a Markov-based model of transition dynamics that accurately predicted bacterial composition within a broader cross-sectional cohort. We found that Lactobacillus iners-dominant, but not Lactobacillus crispatus-dominant, communities have a high probability of transitioning to high-risk states. Simulating clinical interventions by manipulating the underlying transition probabilities, our model predicts that the population prevalence of low-risk microbial communities could most effectively be increased by manipulating the movement between L. iners- and L. crispatus-dominant communities. CONCLUSIONS The Markov model we present here indicates that L. iners-dominant communities have a high probability of transitioning to higher-risk states. We additionally identify transitions to target to increase the prevalence of L. crispatus-dominant communities. These findings may help guide future intervention strategies targeted at reducing bacteria-associated adverse reproductive outcomes among women living in sub-Saharan Africa. Video Abstract.
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Affiliation(s)
- Alexander Munoz
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Harvard Medical School, Boston, MA 02115 USA
| | - Matthew R. Hayward
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Harvard Medical School, Boston, MA 02115 USA
| | - Seth M. Bloom
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Harvard Medical School, Boston, MA 02115 USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Muntsa Rocafort
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
| | - Nomfuneko A. Mafunda
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
| | - Jiawu Xu
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
| | - Nondumiso Xulu
- HIV Pathogenesis Programme (HPP), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mary Dong
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Females Rising through Education, Support, and Health, Durban, KwaZulu-Natal South Africa
- Massachusetts General Hospital, Boston, MA 02114 USA
| | - Krista L. Dong
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Females Rising through Education, Support, and Health, Durban, KwaZulu-Natal South Africa
- Massachusetts General Hospital, Boston, MA 02114 USA
| | - Nasreen Ismail
- HIV Pathogenesis Programme (HPP), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Thumbi Ndung’u
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- HIV Pathogenesis Programme (HPP), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Africa Health Research Institute (AHRI), Durban, South Africa
- Max Planck Institute for Infection Biology, Berlin, Germany
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Musie S. Ghebremichael
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
| | - Douglas S. Kwon
- Ragon Institute of MGH, MIT, and Harvard, 400 Technology Square, Cambridge, MA 02139 USA
- Harvard Medical School, Boston, MA 02115 USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114 USA
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Marcotte H, Larsson PG, Andersen KK, Zuo F, Mikkelsen LS, Brandsborg E, Gray G, Laher F, Otwombe K. An exploratory pilot study evaluating the supplementation of standard antibiotic therapy with probiotic lactobacilli in south African women with bacterial vaginosis. BMC Infect Dis 2019; 19:824. [PMID: 31533663 PMCID: PMC6751625 DOI: 10.1186/s12879-019-4425-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background To reduce acquisition and relapse of bacterial vaginosis (BV), lactobacilli must be maintained in the vaginal microbiome. Probiotic lactobacilli may aid this purpose. We investigated whether vaginal probiotics (containing Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869) would result in vaginal colonisation with lactobacilli in women with and without BV. Methods This prospective, partially randomised, exploratory pilot study was conducted in Soweto, South Africa. Thirty-nine sexually-active, HIV negative women were enrolled from October 2014 to May 2016 into three arms. Women who did not have BV (Group 1, n = 13) self-administered probiotic capsules vaginally once daily for 30 days, then once a week until Day 190. Women diagnosed with BV were randomized into Group 2 (n = 12) or Group 3 (n = 14) and treated with the triple oral antibiotic combination for vaginal discharge syndrome per South African guidelines (cefixime 400 mg stat, doxycycline 100 mg BD for 7 days and metronidazole 2 g stat). Immediately after antibiotic treatment, women in Group 2 self-administered probiotic capsules vaginally once daily for 30 days then vaginally once a week until Day 190. Women in Group 3 were not given lactobacilli. Results During the study, L. rhamnosus DSM 14870 or L. gasseri DSM 14869, were isolated in 5/13 (38.5%) women in Group 1 compared to 10/12 (83.3%) women in Group 2 (p = 0.041). The 1-month and 6-month BV cure rates were similar (P > 0.05) between Group 2 (42 and 25%) compared to Group 3 (36 and 25%). In Group 2, no correlation was observed between the frequency of isolation of the two Lactobacillus strains and the 1-month or 6-month cure rate. Conclusions Supplementation with vaginal probiotic capsules resulted in colonisation of the vagina by the Lactobacillus strains (L. rhamnosus DSM 14870 and L. gasseri DSM 14869) contained in the capsules. We observed low initial cure rates of BV after a stat dose of metronidazole and that the probiotic did not improve BV cure rates or alleviate recurrence which could be due to treatment failure or very limited power of the study. Trial registration Registered at the Pan African Clinical Trial Registry (www.pactr.org) on April 13, 2018 (retrospectively registered). Trial identification number: PACTR201804003327269. Electronic supplementary material The online version of this article (10.1186/s12879-019-4425-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Harold Marcotte
- Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, 14186, Stockholm, Sweden.
| | - Per Göran Larsson
- Department of Obstetrics and Gynaecology Kärnsjukhuset, Skaraborg Hospital, 54185, Skövde, Sweden.,Department of Clinical and Experimental Medicine (IKE), Linköping University, 58183, Linköping, Sweden
| | - Kasper Krogh Andersen
- Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, 14186, Stockholm, Sweden
| | - Fanglei Zuo
- Department of Laboratory Medicine, Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, 14186, Stockholm, Sweden
| | | | | | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 1862, South Africa
| | - Fatima Laher
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 1862, South Africa
| | - Kennedy Otwombe
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 1862, South Africa
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Mu X, Zhao C, Yang J, Wei X, Zhang J, Liang C, Gai Z, Zhang C, Zhu D, Wang Y, Zhang L. Group B Streptococcus colonization induces Prevotella and Megasphaera abundance-featured vaginal microbiome compositional change in non-pregnant women. PeerJ 2019; 7:e7474. [PMID: 31440433 PMCID: PMC6699484 DOI: 10.7717/peerj.7474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 07/15/2019] [Indexed: 12/22/2022] Open
Abstract
Background Previous studies have indicated that variations in the vaginal microbiome result in symptomatic conditions. Group B Streptococcus (GBS) is a significant neonatal pathogen and maternal vaginal colonization has been recognized as an important risk factor for neonatal disease. Therefore, it is important to discover the relationship between the composition of the vaginal microbiome and GBS colonization. This study explores the potential relationship between the composition of the vaginal microbiome and GBS colonization in non-pregnant Chinese women. Methods A total of 22 GBS-positive, non-pregnant women and 44 matched GBS-negative women were recruited for the current study. The composition of the vaginal microbiome was profiled by sequencing the 16S rRNA genes. The microbiome diversity and variation were then evaluated. Results The vaginal microbiome of the 66 subjects enrolled in the current study were compared and the results showed that GBS-positive women exhibited significant vaginal microbial differences compared with the GBS-negative women based on the analysis of similarities (r = 0.306, p < 0.01). The relative abundance of the bacterial genus Lactobacillus (p < 0.01) was significantly lower in the GBS-positive group, while the abundances of the bacterial genera Prevotella (p < 0.01), Megasphaera (p < 0.01), and Streptococcus (p < 0.01) were significantly higher in the GBS-positive group. Discussion The current study addressed significant variations across the communities of the vaginal microbiome in GBS-positive and GBS-negative women in a Chinese cohort, which paves the way for a larger cohort-based clinical validation study and the development of therapeutic probiotics in the future.
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Affiliation(s)
- Xiaofeng Mu
- Tianjin University, Academy of Medical Engineering and Translational Medicine, Tianjin, China.,Clinical Laboratory and Core Research Laboratory; Qingdao Human Microbiome Center & Qingdao Institute of Oncology, The Affiliated Central Hospital of Qingdao University, Qingdao, China.,School of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
| | - Changying Zhao
- Shandong Children's Microbiome Center, Qilu Children's Hospital of Shandong University, Jinan, China.,Research Institute of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Junjie Yang
- College of Life Science, Qilu Normal University, Jinan, China
| | - Xiaofang Wei
- Clinical Laboratory and Core Research Laboratory; Qingdao Human Microbiome Center & Qingdao Institute of Oncology, The Affiliated Central Hospital of Qingdao University, Qingdao, China
| | - Jiaming Zhang
- School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Cheng Liang
- School of Information Science and Engineering, Shandong Normal University, Jinan, China
| | - Zhongtao Gai
- Shandong Children's Microbiome Center, Qilu Children's Hospital of Shandong University, Jinan, China.,Research Institute of Pediatrics, Qilu Children's Hospital of Shandong University, Jinan, China
| | - Chunling Zhang
- Clinical Laboratory and Core Research Laboratory; Qingdao Human Microbiome Center & Qingdao Institute of Oncology, The Affiliated Central Hospital of Qingdao University, Qingdao, China
| | - Dequan Zhu
- Microbiological Laboratory; Department of Infection Management; Department of Neurosurgery, Lin Yi People's Hospital, Linyi, China
| | - Ye Wang
- Clinical Laboratory and Core Research Laboratory; Qingdao Human Microbiome Center & Qingdao Institute of Oncology, The Affiliated Central Hospital of Qingdao University, Qingdao, China
| | - Lei Zhang
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, China
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Williams B, Boucher C, Bushman F, Carrington-Lawrence S, Collman R, Dandekar S, Dang Q, Malaspina A, Paredes R, Wilson C, Nowak P, Klatt N, Lagenaur L, Landay A. A Summary of the Third Annual HIV Microbiome Workshop. AIDS Res Hum Retroviruses 2018; 34:828-834. [PMID: 30105916 DOI: 10.1089/aid.2018.0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Our microbial cotravelers have increasingly apparent roles in both maintaining health and causing disease in several organ systems. Investigators gather annually at the National Institutes of Health to present new discoveries regarding the role of the microbiome in human health and a special focus on persons living with HIV. Here, we summarize the discussions from the third annual Virology Education workshop on the microbiome in HIV, which took place in October of 2017.
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Affiliation(s)
- Brett Williams
- Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
| | - Charles Boucher
- Department of Virosciences, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands
| | - Frederic Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stacy Carrington-Lawrence
- Office of AIDS Research, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, U.S. National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland
| | - Ronald Collman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Satya Dandekar
- Department of Medical Microbiology and Immunology, University of California, Davis, California
| | - Que Dang
- Vaccine Research Program, Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Angela Malaspina
- Vaccine Research Program, Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Roger Paredes
- Institut de Recerca de la SIDA IrsiCaixa i Unitat VIH, Universitat Autònoma de Barcelona, Universitat de Vic, Catalonia, Spain
| | - Cara Wilson
- Department of Medicine, University of Colorado at Denver, Denver, Colorado
| | - Piotr Nowak
- Department of Medicine, Unit of Infectious Diseases, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Nichole Klatt
- Department of Pharmaceutics, Washington National Primate Research Center, University of Washington, Seattle, Washington
| | | | - Alan Landay
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, Illinois
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7
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Gosmann C, Anahtar MN, Handley SA, Farcasanu M, Abu-Ali G, Bowman BA, Padavattan N, Desai C, Droit L, Moodley A, Dong M, Chen Y, Ismail N, Ndung'u T, Ghebremichael MS, Wesemann DR, Mitchell C, Dong KL, Huttenhower C, Walker BD, Virgin HW, Kwon DS. Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women. Immunity 2017; 46:29-37. [PMID: 28087240 DOI: 10.1016/j.immuni.2016.12.013] [Citation(s) in RCA: 413] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 12/20/2022]
Abstract
Elevated inflammation in the female genital tract is associated with increased HIV risk. Cervicovaginal bacteria modulate genital inflammation; however, their role in HIV susceptibility has not been elucidated. In a prospective cohort of young, healthy South African women, we found that individuals with diverse genital bacterial communities dominated by anaerobes other than Gardnerella were at over 4-fold higher risk of acquiring HIV and had increased numbers of activated mucosal CD4+ T cells compared to those with Lactobacillus crispatus-dominant communities. We identified specific bacterial taxa linked with reduced (L. crispatus) or elevated (Prevotella, Sneathia, and other anaerobes) inflammation and HIV infection and found that high-risk bacteria increased numbers of activated genital CD4+ T cells in a murine model. Our results suggest that highly prevalent genital bacteria increase HIV risk by inducing mucosal HIV target cells. These findings might be leveraged to reduce HIV acquisition in women living in sub-Saharan Africa.
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Affiliation(s)
- Christina Gosmann
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Melis N Anahtar
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Scott A Handley
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Mara Farcasanu
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA
| | - Galeb Abu-Ali
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Brittany A Bowman
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA
| | - Nikita Padavattan
- HIV Pathogenesis Programme, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
| | - Chandni Desai
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Lindsay Droit
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Amber Moodley
- Females Rising through Education, Support, and Health, Durban, KwaZulu-Natal, 4066, South Africa
| | - Mary Dong
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Females Rising through Education, Support, and Health, Durban, KwaZulu-Natal, 4066, South Africa
| | - Yuezhou Chen
- Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Nasreen Ismail
- HIV Pathogenesis Programme, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
| | - Thumbi Ndung'u
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; HIV Pathogenesis Programme, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
| | - Musie S Ghebremichael
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Duane R Wesemann
- Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Caroline Mitchell
- Vincent Obstetrics & Gynecology, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Krista L Dong
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Females Rising through Education, Support, and Health, Durban, KwaZulu-Natal, 4066, South Africa
| | - Curtis Huttenhower
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Bruce D Walker
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02115, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Herbert W Virgin
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Douglas S Kwon
- Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Cambridge, MA 02139, USA; Harvard Medical School, Boston, MA 02115, USA; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02115, USA.
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