3 years ago

Microbial composition predicts genital tract inflammation and persistent bacterial vaginosis in adolescent South African women.

Nicola Mulder, Enock Havyarimana, Katie Lennard, Nonhlanhla N Mkhize, David A Lewis, Linda-Gail Bekker, Jo-Ann S Passmore, Heather B Jaspan, Shameem Z Jaumdally, Gerrit Botha, Glenda Gray, Shaun L Barnabas, Anna Blakney, Smritee Dabee
Young African females are at 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 women aged 16-22 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, microbiome compositional subtype and hormonal contraception were significantly associated with genital inflammation. We identified 40 taxa significantly associated with inflammation, including those previously reported (Prevotella, Sneathia, Aerococcus, Fusobacterium, Gemella) as well as several novel taxa (including increased BVAB1/2/3, Prevotella amnii, Prevotella pallens, Parvimonas micra, Megasphaera, Gardnerella vaginalis, Atopobium vaginae, and decreased Lactobacillus reuteri_cluster, L. crispatus, L. jensenii and L. 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 BV; this subtype could be predicted with high specificity and sensitivity based on Nugent score (≥ 9) or BVAB1 abundance. We propose that women in this BVAB1-dominated subtype may have chronic genital inflammation due to persistent BV, which may place them at particularly high risk of HIV infection.

Publisher URL: http://doi.org/10.1128/IAI.00410-17

DOI: 10.1128/IAI.00410-17

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