title: Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis.
abstract: BACKGROUND
  Fastidious bacteria have been associated with bacterial vaginosis (BV) using PCR methods. We assessed the prevalence of these bacteria in HIV-1 infected women and their relationship with vaginal pH and shedding of HIV-1 RNA.
  
  
  METHODS
  64 cervicovaginal lavage (CVL) samples were collected from 51 women. Vaginal microbiota were characterized using 8 bacterium-specific quantitative PCR assays.
  
  
  RESULTS
  Women with the fastidious bacteria Bacterial Vaginosis Associated Bacterium (BVAB) 1, 2, and 3 showed a trend to increased HIV-1 shedding (OR 2.59-3.07, P = .14-.17). Absence of Lactobacillus crispatus (P < .005) and presence of BVAB2 (P < .001) were associated with elevated vaginal pH. BVAB1, 2, and 3 were highly specific indicators of BV in HIV-infected women, with specificities of 89%-93%.
  
  
  CONCLUSIONS
  Fastidious bacteria (BVAB 1, 2, and 3) remain specific indicators of BV in HIV-infected women, and BVAB2 may contribute to the elevated vaginal pH that is a hallmark of this syndrome.
authors.affiliation: Department of Obstetrics & Gynecology, University of Washington, P.O. Box 356460, Seattle, WA 98195, USA. camitch@u.washington.edu
authors.forename: Caroline
authors.initials: C
authors.lastname: Mitchell
authors.forename: Carla
authors.initials: C
authors.lastname: Moreira
authors.forename: David
authors.initials: D
authors.lastname: Fredricks
authors.forename: Kathleen
authors.initials: K
authors.lastname: Paul
authors.forename: Angela M
authors.initials: AM
authors.lastname: Caliendo
authors.forename: Jaclynn
authors.initials: J
authors.lastname: Kurpewski
authors.forename: Jessica
authors.initials: J
authors.lastname: Ingersoll
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000378:metabolism / Q000382:microbiology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014621:Vagina / Q000378:metabolism / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000378:metabolism / Q000382:microbiology* / Q000821:virology*; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral