Detection of fastidious vaginal bacteria in women with HIV infection and bacterial vaginosis.
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.
Mitchell
Caroline
C
Department of Obstetrics & Gynecology, University of Washington, P.O. Box 356460, Seattle, WA 98195, USA. camitch@u.washington.edu
Moreira
Carla
C
Fredricks
David
D
Paul
Kathleen
K
Caliendo
Angela M
AM
Kurpewski
Jaclynn
J
Ingersoll
Jessica
J
Cu-Uvin
Susan
S
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
D012367:RNA, Viral