title: The vaginal microbiota over an 8- to 10-year period in a cohort of HIV-infected and HIV-uninfected women.
abstract: BACKGROUND
  We identified predominant vaginal microbiota communities, changes over time, and how this varied by HIV status and other factors in a cohort of 64 women.
  
  
  METHODS
  Bacterial DNA was extracted from reposited cervicovaginal lavage samples collected annually over an 8-10 year period from Chicago Women's Interagency HIV Study participants: 22 HIV-negative, 22 HIV-positive with stable infection, 20 HIV-positive with progressive infection. The vaginal microbiota was defined by pyrosequencing of the V1/V2 region of the 16S rRNA gene. Scheduled visits included Bacterial vaginsosis (BV) screening; clinically detected cases were referred for treatment. Hierarchical clustering identified bacterial community state types (CST). Multinomial mixed effects modeling determined trends over time in CST, by HIV status and other factors.
  
  
  RESULTS
  The median follow-up time was 8.1 years (range 5.5-15.3). Six CSTs were identified. The mean relative abundance (RA) of Lactobacillus spp. by CST (with median number of bacterial taxa) was: CST-1-25.7% (10), CST-2-27.1% (11), CST-3-34.6% (9), CST-4-46.8% (9), CST-5-57.9% (4), CST-6-69.4% (2). The two CSTs representing the highest RA of Lactobacillus and lowest diversity increased with each additional year of follow-up (CST-5, adjusted odds ratio (aOR) = 1.62 [95% CI: 1.34-1.94]; CST-6, aOR = 1.57 [95 CI: 1.31-1.89]), while the two CSTs representing lowest RA of Lactobacillus and higher diversity decreased with each additional year (CST-1, aOR = 0.89 [95% CI: 0.80-1.00]; CST-2, aOR = 0.86 [95% CI: 0.75-0.99]). There was no association between HIV status and CST at baseline or over time. CSTs representing lower RA of Lactobacillus were associated with current cigarette smoking.
  
  
  CONCLUSIONS
  The vaginal microbial community significantly improved over time in this cohort of women with HIV and at high risk for HIV who had regular detection and treatment referral for BV.
authors: Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, Illinois, United States of America.
authors: Supriya D
authors: SD
authors: Mehta
authors: Department of Bioengineering, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, United States of America.
authors: Brock
authors: B
authors: Donovan
authors: The Core Center at Cook County Health and Hospital System, Chicago, Illinois, United States of America.
authors: Kathleen M
authors: KM
authors: Weber
authors: The Core Center at Cook County Health and Hospital System, Chicago, Illinois, United States of America.
authors: Mardge
authors: M
authors: Cohen
authors: Institute for Genome Sciences, University of Maryland, and Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America.
authors: Jacques
authors: J
authors: Ravel
authors: Institute for Genome Sciences, University of Maryland, and Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America.
authors: Pawel
authors: P
authors: Gajer
authors: Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois, United States of America.
authors: Douglas
authors: D
authors: Gilbert
authors: Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois, United States of America.
authors: Derick
authors: D
authors: Burgad
authors: Department of Immunology & Microbiology, Rush University Medical Center, Chicago, Illinois, United States of America.
authors: Greg T
authors: GT
authors: Spear
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D015331:Cohort Studies; D060085:Coinfection; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000382:microbiology* / Q000821:virology; D006801:Humans; D007778:Lactobacillus / Q000145:classification / Q000235:genetics; D054892:Metagenome; D064307:Microbiota; D012336:RNA, Ribosomal, 16S; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D013997:Time Factors; D014621:Vagina / Q000382:microbiology*; D055815:Young Adult
chemical_list: D012336:RNA, Ribosomal, 16S