在 HIV 病毒载量未得到抑制的 HIV 感染者和复发性细菌性阴道病女性中，观察到不同且多样的厌氧微生物群：一项队列研究。

Different and diverse anaerobic microbiota were seen in women living with HIV with unsuppressed HIV viral load and in women with recurrent bacterial vaginosis: a cohort study.

机构信息

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.

Women's Health Research Institute, Vancouver, BC, Canada.

出版信息

BJOG. 2020 Jan;127(2):250-259. doi: 10.1111/1471-0528.15930. Epub 2019 Oct 6.

DOI:10.1111/1471-0528.15930

PMID:31498547

Abstract

OBJECTIVE

To compare the vaginal microbiota of women living with HIV (WLWH) with the vaginal microbiota of women with recurrent bacterial vaginosis (BV) and healthy women without HIV to determine if there are differences in the vaginal microbiome, what factors influence these differences, and to characterise HIV clinical parameters including viral load and CD4 count in relation to the vaginal microbiome.

DESIGN

Observational cohort study.

SETTING

Canada.

POPULATION

Women aged 18-49 years who were premenopausal and not pregnant were recruited into three cohorts: healthy women, WLWH and women with recurrent BV.

METHODS

Demographic and clinical data were collected via interviews and medical chart reviews. Vaginal swabs were collected for Gram-stain assessment and microbiome profiling using the cpn60 barcode sequence.

MAIN OUTCOME MEASURES

To compare overall community composition differences, we used compositional data analysis methods, hierarchical clustering and Kruskal-Wallis tests where appropriate.

RESULTS

Clinical markers such as odour and abnormal discharge, but not irritation, were associated with higher microbial diversity. WLWH with unsuppressed HIV viral loads were more likely than other groups to have non-Gardnerella-dominated microbiomes. HIV was associated with higher vaginal microbial diversity and this was related to HIV viral load, with unsuppressed women demonstrating significantly higher relative abundance of Megasphaera genomosp. 1, Atopobium vaginae and Clostridiales sp. (all P < 0.05) compared with all other groups.

CONCLUSIONS

In WLWH, unsuppressed HIV viral loads were associated with a distinct dysbiotic profile consisting of very low levels of Lactobacillus and high levels of anaerobes.

TWEETABLE ABSTRACT

Vaginal microbiomes in WLWH with viral load >50 copies/ml have distinct dysbiotic profiles with high levels of anaerobes.

摘要

目的

比较 HIV 感染者（WLWH）、复发性细菌性阴道病（BV）和无 HIV 的健康女性的阴道微生物群，以确定阴道微生物组是否存在差异，哪些因素影响这些差异，并描述与阴道微生物组相关的 HIV 临床参数，包括病毒载量和 CD4 计数。

设计

观察性队列研究。

地点

加拿大。

人群

招募了三个队列的 18-49 岁绝经前且未怀孕的女性：健康女性、WLWH 和复发性 BV 女性。

方法

通过访谈和病历回顾收集人口统计学和临床数据。采集阴道拭子进行革兰氏染色评估和微生物组分析，使用 cpn60 条码序列。

主要观察指标

为了比较总体群落组成差异，我们使用组成数据分析方法、层次聚类和 Kruskal-Wallis 检验。

结果

临床标志物（如气味和异常分泌物），而不是刺激，与更高的微生物多样性相关。未抑制 HIV 病毒载量的 WLWH 比其他组更有可能出现非 Gardnerella 主导的微生物组。HIV 与阴道微生物多样性增加有关，这与 HIV 病毒载量有关，与所有其他组相比，未抑制的女性具有更高的相对丰度的 Megasphaera genomosp. 1、阴道阿托波氏菌和梭状芽胞杆菌（均 P < 0.05）。