title: Interaction between lactobacilli, bacterial vaginosis-associated bacteria, and HIV Type 1 RNA and DNA Genital shedding in U.S. and Kenyan women.
abstract: Bacterial vaginosis has been associated with genital HIV-1 shedding; however, the effect of specific vaginal bacterial species has not been assessed. We tested cervicovaginal lavage from HIV-1-seropositive women for common Lactobacillus species: L. crispatus, L. jensenii, and seven BV-associated species: BVAB1, BVAB2, BVAB3, Leptotrichia, Sneathia, Megasphaera, and Atopobium spp. using quantitative PCR. We used linear and Poisson regression to evaluate associations between vaginal bacteria and genital HIV-1 RNA and DNA. Specimens from 54 U.S. (310 visits) and 50 Kenyan women (137 visits) were evaluated. Controlling for plasma viral load, U.S. and Kenyan women had similar rates of HIV-1 RNA (19% of visits vs. 24%; IRR=0.95; 95% CI 0.61, 1.49) and DNA shedding (79% vs. 76%; IRR=0.90; 0.78, 1.05). At visits during antiretroviral therapy (ART), the likelihood of detection of HIV-1 RNA shedding was greater with BVAB3 (IRR=3.16; 95% CI 1.36, 7.32), Leptotrichia, or Sneathia (IRR=2.13; 1.02, 4.72), and less with L. jensenii (IRR=0.39; 0.18, 0.84). At visits without ART, only L. crispatus was associated with a lower likelihood of HIV-1 RNA detection (IRR=0.6; 0.40, 0.91). Vaginal Lactobacillus species were associated with lower risk of genital HIV-1 shedding, while the presence of certain BV-associated species may increase that risk.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Mitchell
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Balkus
authors.forename: David
authors.initials: D
authors.lastname: Fredricks
authors.forename: Congzhou
authors.initials: C
authors.lastname: Liu
authors.forename: Jennifer
authors.initials: J
authors.lastname: McKernan-Mullin
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Frenkel
authors.forename: Christina
authors.initials: C
authors.lastname: Mwachari
authors.forename: Amneris
authors.initials: A
authors.lastname: Luque
authors.forename: Susan E
authors.initials: SE
authors.lastname: Cohn
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.forename: Robert
authors.initials: R
authors.lastname: Coombs
authors.forename: Jane
authors.initials: J
authors.lastname: Hitti
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000378:metabolism*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000382:microbiology / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D007630:Kenya; D007778:Lactobacillus; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000378:metabolism*; D014481:United States; D014621:Vagina / Q000382:microbiology / Q000821:virology*; D016585:Vaginosis, Bacterial / Q000150:complications / Q000382:microbiology / Q000821:virology*; D017201:Virus Shedding / Q000502:physiology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral