The Cervicovaginal Microbiota and Its Associations With Human Papillomavirus Detection in HIV-Infected and HIV-Uninfected Women
Open Access
- 11 August 2016
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 214 (9), 1361-1369
- https://doi.org/10.1093/infdis/jiw374
Abstract
Background. Bacterial vaginosis (BV) is characterized by low abundance of Lactobacillus species, high pH, and immune cell infiltration and has been associated with an increased risk of human papillomavirus (HPV) infection. We molecularly assessed the cervicovaginal microbiota over time in human immunodeficiency virus (HIV)–infected and HIV-uninfected women to more comprehensively study the HPV-microbiota relationship, controlling for immune status. Methods. 16S ribosomal RNA gene amplicon pyrosequencing and HPV DNA testing were conducted annually in serial cervicovaginal lavage specimens obtained over 8–10 years from African American women from Chicago, of whom 22 were HIV uninfected, 22 were HIV infected with a stable CD4+ T-cell count of > 500 cells/mm3, and 20 were HIV infected with progressive immunosuppression. Vaginal pH was serially measured. Results. The relative abundances of Lactobacillus crispatus and other Lactobacillus species were inversely associated with vaginal pH (all P < .001). High (vs low) L. crispatus relative abundance was associated with decreased HPV detection (odds ratio, 0.48; 95% confidence interval, .24–.96; Ptrend = .03) after adjustment for repeated observation and multiple covariates, including pH and study group. However, there were no associations between HPV and the relative abundance of Lactobacillus species as a group, nor with Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii individually. Conclusions. L. crispatus may have a beneficial effect on the burden of HPV in both HIV-infected and HIV-uninfected women (independent of pH).Keywords
Funding Information
- National Cancer Institute
- NCI (R01-CA-085178, R01-CA-174634, P30-CA-013330)
- NIH
- American Recovery Reinvestment Act
- National Institute of Allergy and Infectious Diseases (NIAID)
- Women's Interagency HIV Study
- NIAID (P30-AI-051519)
- WIHS
- UAB-MS WIHS (U01-AI-103401)
- Atlanta WIHS (U01-AI-103408)
- Bronx WIHS (Kathryn Anastos) (U01-AI-035004)
- Brooklyn WIHS (U01-AI- 031834)
- Chicago WIHS (U01-AI-034993)
- Metropolitan Washington WIHS (U01-AI-034994)
- Miami WIHS (U01-AI-103397)
- UNC WIHS (U01-AI-103390)
- Connie Wofsy Women′s HIV Study, Northern California (U01- AI-034989)
- WIHS Data Management and Analysis Center (U01-AI-042590)
- Southern California WIHS (U01-HD-032632)
- WIHS I-WIHS IV
- NIAID
- Eunice Kennedy Shriver National Institute
- Child Health and Human Development
- NCI
- National Institute on Drug Abuse
- National Institute of Mental Health
- National Institute of Dental and Craniofacial Research
- National Institute on Alcohol Abuse and Alcoholism
- National Institute on Deafness and Other Communication Disorders
- National Institutes of Health (UL1-TR000004)
- UCSF CTSA (UL1-TR000454)
- Atlanta CTSA
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