Cervicovaginal microbiome and HIV/ STI

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

Deviation from a Lactobacillus-dominated cervicovaginal microbiome may increase the risk of HIV and other sexually transmitted infections (STIs). However, little is known about the exact nature of these microbiological changes. In this study, we concluded that L. crispatus-dominated, 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. Cervical samples of 174 Rwandan female sex workers were analyzed using a DNA hybridization microarray and HIV-1 RNA was measured in cervicovaginal lavages. Six microbiome clusters were identified, representing a gradient from low diversity dominated by Lactobacillus crispatus (cluster R-I) and L. iners (R-II), to intermediate (R-V) and high 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, herpes simplex virus type 2 (HSV-2), and human papillomavirus (HPV). The prevalence of viral STIs increased with increasing bacterial diversity. Furthermore, only 10% of HIV-positive women in clusters R-I/R-II, compared to 40% in cluster R-V, and 42% in clusters R-III/R-IV/R-VI had detectable cervicovaginal HIV-1 RNA. Future research should focus on temporal relationships and methods to establish a L. crispatus-dominated microbiome.


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

Authored by: Hanneke Borgdorff, Evgeni Tsivtsivadze, Rita Verhelst, Massimo Marzorati, Suzanne Jurriaans, Ndayisaba Gilles François, Frank H Schuren, Janneke van de Wijgert

In: The ISME Journal, 2014, 6 March | doi:10.1038/ismej.2014.26