title: The Cervicovaginal Microbiota and Its Associations With Human Papillomavirus Detection in HIV-Infected and HIV-Uninfected Women.
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).
authors: Albert Einstein College of Medicine, Bronx.
authors: Laura L
authors: LL
authors: Reimers
authors: University of Illinois-Chicago.
authors: Supriya D
authors: SD
authors: Mehta
authors: Washington University School of Medicine, St. Louis, Missouri.
authors: L Stewart
authors: LS
authors: Massad
authors: Albert Einstein College of Medicine, Bronx.
authors: Robert D
authors: RD
authors: Burk
authors: Albert Einstein College of Medicine, Bronx.
authors: Xianhong
authors: X
authors: Xie
authors: University of Maryland School of Medicine.
authors: Jacques
authors: J
authors: Ravel
authors: Rush Medical Center.
authors: Mardge H
authors: MH
authors: Cohen
authors: University of California-San Francisco.
authors: Joel M
authors: JM
authors: Palefsky
authors: Cook County Health and Hospitals System/Hektoen Institute of Medicine, Chicago, Illinois.
authors: Kathleen M
authors: KM
authors: Weber
authors: Albert Einstein College of Medicine, Bronx.
authors: Xiaonan
authors: X
authors: Xue
authors: Albert Einstein College of Medicine, Bronx.
authors: Kathryn
authors: K
authors: Anastos
authors: Maimonides Medical Center, Brooklyn, New York.
authors: Howard
authors: H
authors: Minkoff
authors: Montefiore Medical Center, Bronx, New York.
authors: Jessica
authors: J
authors: Atrio
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Gypsyamber
authors: G
authors: D'Souza
authors: Albert Einstein College of Medicine, Bronx.
authors: Qian
authors: Q
authors: Ye
authors: Georgetown University, Washington D.C.
authors: Christine
authors: C
authors: Colie
authors: Albert Einstein College of Medicine, Bronx.
authors: Christine P
authors: CP
authors: Zolnik
authors: Rush Medical Center.
authors: Gregory T
authors: GT
authors: Spear
authors: Albert Einstein College of Medicine, Bronx.
authors: Howard D
authors: HD
authors: Strickler
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count / Q000379:methods; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002584:Cervix Uteri / Q000276:immunology / Q000382:microbiology* / Q000821:virology*; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000209:etiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D007778:Lactobacillus / Q000276:immunology / Q000502:physiology; D064307:Microbiota / Q000235:genetics* / Q000276:immunology; D027383:Papillomaviridae / Q000235:genetics* / Q000276:immunology; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D014621:Vagina / Q000276:immunology / Q000382:microbiology* / Q000821:virology*; D016585:Vaginosis, Bacterial / Q000150:complications / Q000276:immunology / Q000382:microbiology / Q000821:virology
chemical_list: D004279:DNA, Viral; D012336:RNA, Ribosomal, 16S
keywords: HIV; HPV; L. crispatus; Lactobacillus species; human papillomavirus; microbiota