Muchaneta Gudza-Mugabe1,2,3, Enock Havyarimana1, Shameem Jaumdally1, Kirsty Lee Garson4, Katie Lennard4, Andrew Tarupiwa2, Fortunate Mugabe5, Tarisai Marere6, Rooyen T Mavenyengwa3, Lindi Masson1, Heather B Jaspan1,7,8. 1. Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa. 2. National Microbiology Reference Laboratory, Harare, Zimbabwe. 3. Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe. 4. Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. 5. Harare Central Hospital, Zimbabwe, Harare, Zimbabwe. 6. College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe. 7. Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, Washington, USA. 8. Departments of Pediatrics and Global Health, University of Washington, Seattle, Washington, USA.
Abstract
BACKGROUND: During pregnancy, the vaginal microbiota is relatively stable. However, African women have more diverse vaginal microbiota than their European counterparts, in addition to high human immunodeficiency virus (HIV) prevalence and risk of adverse birth outcomes. Although HIV is associated with alterations in vaginal microbiota and inflammation in nonpregnant women, these relationships are underexplored in pregnant women. METHODS: In this study, we characterize the vaginal microbiota and immune factors in pregnant African women who were HIV-uninfected (n = 314) versus HIV-infected (n = 42). Mucosal samples were collected once at the enrollment visit (between 15 and 35 weeks of gestation) and women were followed until delivery. RESULTS: Vaginal microbial communities of pregnant women with HIV were significantly more diverse than women without HIV (P = .004), with community structure also differing by HIV status (P = .002, R2 = 0.02). Human immunodeficiency virus infection was also associated with increased risk of preterm birth (PTB) (31% versus 15.3%; P = .066). In a multivariate analysis, HIV infection was independently associated with diverse vaginal community state type (CST)-IVA (P = .005) and CST-IVB (P = .018) as well as PTB (P = .049). No association between HIV status and cytokine concentrations was found. CONCLUSIONS: Longitudinal studies with accurate gestational age assessment would be important to confirm these relationships.
BACKGROUND: During pregnancy, the vaginal microbiota is relatively stable. However, African women have more diverse vaginal microbiota than their European counterparts, in addition to high human immunodeficiency virus (HIV) prevalence and risk of adverse birth outcomes. Although HIV is associated with alterations in vaginal microbiota and inflammation in nonpregnant women, these relationships are underexplored in pregnant women. METHODS: In this study, we characterize the vaginal microbiota and immune factors in pregnant African women who were HIV-uninfected (n = 314) versus HIV-infected (n = 42). Mucosal samples were collected once at the enrollment visit (between 15 and 35 weeks of gestation) and women were followed until delivery. RESULTS: Vaginal microbial communities of pregnant women with HIV were significantly more diverse than women without HIV (P = .004), with community structure also differing by HIV status (P = .002, R2 = 0.02). Human immunodeficiency virus infection was also associated with increased risk of preterm birth (PTB) (31% versus 15.3%; P = .066). In a multivariate analysis, HIV infection was independently associated with diverse vaginal community state type (CST)-IVA (P = .005) and CST-IVB (P = .018) as well as PTB (P = .049). No association between HIV status and cytokine concentrations was found. CONCLUSIONS: Longitudinal studies with accurate gestational age assessment would be important to confirm these relationships.
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