Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.
Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.
J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):79-87. doi: 10.1097/QAI.0000000000002406.
Although nonoptimal vaginal bacteria and inflammation have been associated with increased HIV risk, the upstream drivers of these phenotypes are poorly defined in young African women.
Mombasa, Kenya.
We characterized vaginal microbiome and cytokine profiles of sexually active young women aged 14-24 years (n = 168) in 3 study groups: those engaging in formal sex work, in transactional sex, and nonsex workers. Vaginal secretions were collected using self-inserted SoftCup, and assayed for cytokines and vaginal microbiome through multiplex ELISA and 16S rRNA sequencing, respectively. Epidemiological data were captured using a validated questionnaire.
The median age of participants was 20 years (interquartile range: 18-22 years). Approximately two-thirds of young women (105/168) had vaginal microbial communities characterized by Gardnerella and/or Prevotella spp. dominance; a further 29% (49/168) were predominantly Lactobacillus iners. Microbiome clustering explained a large proportion of cytokine variation (>50% by the first 2 principal components). Age was not associated with vaginal microbial profiles in bivariable or multivariable analyses. Women self-identifying as sex workers had increased alpha (intraindividual) diversity, independent of age, recent sexual activity, HIV, and other sexually transmitted infections (beta = 0.47, 95% confidence interval: 0.05 to 0.90, P = 0.03). Recent sex (number of partners or sex acts last week, time since last vaginal sex) correlated with increased alpha diversity, particularly in participants who were not involved in sex work.
Nonoptimal vaginal microbiomes were common in young Kenyan women and associated with sex work and recent sexual activity, but independent of age. Restoring optimal vaginal microflora may represent a useful HIV prevention strategy.
尽管阴道细菌和炎症的非最佳状态与 HIV 风险增加有关，但在年轻的非洲女性中，这些表型的上游驱动因素仍未得到明确界定。
肯尼亚蒙巴萨。
我们对 14-24 岁的有性行为的年轻女性（n=168）进行了阴道微生物群和细胞因子谱的特征描述，这些女性分为三组：从事正规性工作的、进行交易性性行为的和非性工作者。使用自行插入的 SoftCup 收集阴道分泌物，并通过多重 ELISA 和 16S rRNA 测序分别检测细胞因子和阴道微生物群。通过验证问卷收集流行病学数据。
参与者的中位年龄为 20 岁（四分位距：18-22 岁）。大约三分之二的年轻女性（105/168）的阴道微生物群落以 Gardnerella 和/或 Prevotella spp. 为主导；另有 29%（49/168）以 L.iners 为主导。微生物群聚类解释了细胞因子变化的很大一部分（通过前两个主成分解释超过 50%）。在单变量和多变量分析中，年龄与阴道微生物群特征无关。自我认同为性工作者的女性具有更高的个体内多样性，这与年龄、近期性行为、HIV 和其他性传播感染无关（β=0.47，95%置信区间：0.05-0.90，P=0.03）。近期性行为（上周的性伴侣数量或性行为次数、上次阴道性行为后的时间）与个体内多样性增加相关，特别是在不参与性工作的参与者中。
非最佳阴道微生物群在肯尼亚年轻女性中很常见，与性工作和近期性行为有关，但与年龄无关。恢复阴道微生态可能是一种有用的 HIV 预防策略。
