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Infect Immun. 2017 Dec 19;86(1). pii: e00410-17. doi: 10.1128/IAI.00410-17. Print 2018 Jan.

Microbial Composition Predicts Genital Tract Inflammation and Persistent Bacterial Vaginosis in South African Adolescent Females.

Lennard K1,2, Dabee S1,3, Barnabas SL1,3, Havyarimana E1,3,4, Blakney A5, Jaumdally SZ1,3, Botha G1,2, Mkhize NN6, Bekker LG1,4, Lewis DA7,8,9,6, Gray G10,11, Mulder N1,2, Passmore JS1,3,12, Jaspan HB13,3,14,15,16.

Author information

1
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
2
Department of Integrative Biomedical Sciences, University of Cape Town, Cape Town, South Africa.
3
Department of Pathology, University of Cape Town, Cape Town, South Africa.
4
Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
5
Department of Bioengineering, University of Washington, Seattle, Washington, USA.
6
National Institute for Communicable Diseases, Sandringham, Johannesburg, South Africa.
7
Western Sydney Sexual Health Centre, Parramatta, Australia.
8
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
9
Sydney Medical School-Westmead, University of Sydney, Sydney, Australia.
10
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
11
South African Medical Research Council, Cape Town, South Africa.
12
National Health Laboratory Service, Johannesburg, South Africa.
13
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa hbjaspan@gmail.com.
14
Seattle Children's Research Institute, Seattle, Washington, USA.
15
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
16
Department of Global Health, University of Washington, Seattle, Washington, USA.

Abstract

Young African females are at an increased risk of HIV acquisition, and genital inflammation or the vaginal microbiome may contribute to this risk. We studied these factors in 168 HIV-negative South African adolescent females aged 16 to 22 years. Unsupervised clustering of 16S rRNA gene sequences revealed three clusters (subtypes), one of which was strongly associated with genital inflammation. In a multivariate model, the microbiome compositional subtype and hormonal contraception were significantly associated with genital inflammation. We identified 40 taxa significantly associated with inflammation, including those reported previously (Prevotella, Sneathia, Aerococcus, Fusobacterium, and Gemella) as well as several novel taxa (including increased frequencies of bacterial vaginosis-associated bacterium 1 [BVAB1], BVAB2, BVAB3, Prevotella amnii, Prevotella pallens, Parvimonas micra, Megasphaera, Gardnerella vaginalis, and Atopobium vaginae and decreased frequencies of Lactobacillus reuteri, Lactobacillus crispatus, Lactobacillus jensenii, and Lactobacillus iners). Women with inflammation-associated microbiomes had significantly higher body mass indices and lower levels of endogenous estradiol and luteinizing hormone. Community functional profiling revealed three distinct vaginal microbiome subtypes, one of which was characterized by extreme genital inflammation and persistent bacterial vaginosis (BV); this subtype could be predicted with high specificity and sensitivity based on the Nugent score (≥9) or BVAB1 abundance. We propose that women with this BVAB1-dominated subtype may have chronic genital inflammation due to persistent BV, which may place them at a particularly high risk for HIV infection.

KEYWORDS:

16S RNA; HIV susceptibility; HIV target cells; female genital tract microbiome; inflammation; vaginal microbiome

PMID:
29038128
PMCID:
PMC5736802
DOI:
10.1128/IAI.00410-17
[Indexed for MEDLINE]
Free PMC Article

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