Borgdorff Hanneke, Tsivtsivadze Evgeni, Verhelst Rita, Marzorati Massimo, Jurriaans Suzanne, Ndayisaba Gilles F, Schuren Frank H, van de Wijgert Janneke H H M
Amsterdam Institute for Global Health and Development (AIGHD) and Department of Global Health, Academic Medical Center, Amsterdam, The Netherlands.
TNO Microbiology and Systems Biology, Zeist, The Netherlands.
ISME J. 2014 Sep;8(9):1781-93. doi: 10.1038/ismej.2014.26. Epub 2014 Mar 6.
Cervicovaginal microbiota not dominated by lactobacilli may facilitate transmission of HIV and other sexually transmitted infections (STIs), as well as miscarriages, preterm births and sepsis in pregnant women. However, little is known about the exact nature of the microbiological changes that cause these adverse outcomes. In this study, cervical samples of 174 Rwandan female sex workers were analyzed cross-sectionally using a phylogenetic microarray. Furthermore, HIV-1 RNA concentrations were measured in cervicovaginal lavages of 58 HIV-positive women among them. We identified six microbiome clusters, representing a gradient from low semi-quantitative abundance and diversity dominated by Lactobacillus crispatus (cluster R-I, with R denoting 'Rwanda') and L. iners (R-II) to intermediate (R-V) and high abundance and diversity (R-III, R-IV and R-VI) dominated by a mixture of anaerobes, including Gardnerella, Atopobium and Prevotella species. Women in cluster R-I were less likely to have HIV (P=0.03), herpes simplex virus type 2 (HSV-2; P<0.01), and high-risk human papillomavirus (HPV; P<0.01) and had no bacterial STIs (P=0.15). Statistically significant trends in prevalence of viral STIs were found from low prevalence in cluster R-I, to higher prevalence in clusters R-II and R-V, and highest prevalence in clusters R-III/R-IV/R-VI. Furthermore, only 10% of HIV-positive women in clusters R-I/R-II, compared with 40% in cluster R-V, and 42% in clusters R-III/R-IV/R-VI had detectable cervicovaginal HIV-1 RNA (Ptrend=0.03). We conclude that L. crispatus-dominated, and to a lesser extent L. iners-dominated, cervicovaginal microbiota are associated with a lower prevalence of HIV/STIs and a lower likelihood of genital HIV-1 RNA shedding.
以非乳酸杆菌为主的宫颈阴道微生物群可能会促进艾滋病毒和其他性传播感染（STIs）的传播，以及导致孕妇流产、早产和败血症。然而，对于导致这些不良后果的微生物变化的确切性质，人们知之甚少。在本研究中，使用系统发育微阵列对174名卢旺达女性性工作者的宫颈样本进行了横断面分析。此外，还对其中58名HIV阳性女性的宫颈阴道灌洗液中的HIV-1 RNA浓度进行了测量。我们识别出六个微生物群簇，代表了一个梯度，从以卷曲乳酸杆菌（R-I簇，R表示“卢旺达”）和惰性乳酸杆菌（R-II）为主的低半定量丰度和多样性，到以包括加德纳菌属、阿托波菌属和普雷沃菌属在内的厌氧菌混合物为主的中等（R-V）和高丰度及多样性（R-III、R-IV和R-VI）。R-I簇中的女性感染艾滋病毒（P=0.03）、2型单纯疱疹病毒（HSV-2；P<0.01）和高危人乳头瘤病毒（HPV；P<0.01）的可能性较小，且没有细菌性性传播感染（P=0.15）。从R-I簇中的低患病率，到R-II和R-V簇中的较高患病率，再到R-III/R-IV/R-VI簇中的最高患病率，发现了病毒性性传播感染患病率的统计学显著趋势。此外，R-I/R-II簇中只有10%的HIV阳性女性宫颈阴道可检测到HIV-1 RNA，而R-V簇中这一比例为40%，R-III/R-IV/R-VI簇中为42%（P趋势=0.03）。我们得出结论，以卷曲乳酸杆菌为主，以及在较小程度上以惰性乳酸杆菌为主的宫颈阴道微生物群与较低的艾滋病毒/性传播感染患病率以及较低的生殖器HIV-1 RNA脱落可能性相关。
