Comparison of the Diversity of the Vaginal Microbiota in HIV‐Infected and HIV‐Uninfected Women with or without Bacterial Vaginosis

Abstract

Background This study investigated whether HIV-infection is associated with a change in diversity of genital microbiota in women. Methods Amplicon length heterogeneity PCR (LH-PCR) and pyrosequencing of the 16S rRNA gene were used to analyze diversity of the microbiota from HIV-positive (HIV+) and HIV-negative (HIV-) women with or without bacterial vaginosis (BV). Results LH-PCR analysis showed significantly more diversity in BV-positive (BV+) women than in BV-negative (BV-) women, but no significant difference between HIV+ women and HIV- women. Pyrosequencing revealed that Lactobacillus constituted a median of 96% of the bacteria in BV- women. BV+ women had a significantly higher number of taxa found at ≥ 1% of the microbiota (median of 11). Common taxa in BV were Prevotella, Megasphaera, Gardnerella, Coriobacterineae, Lachnospira, and Sneathia. There was a trend (p=0.07) toward a higher number of taxa in HIV+BV+ compared to HIV-BV+ women. Propionibacterineae, Citrobacter and Anaerococcus were found only in HIV+ women (p<0.05). Conclusions This study showed that both LH-PCR and pyrosequencing differentiated BV+ from BV- microbiota and that pyrosequencing indicated a trend toward increased diversity in BV+HIV+ suggesting that HIV-infection is associated with changes in diversity of genital microbiota.

Lactobacillus-dominated cervicovaginal microbiota associated with reduced HIV/STI prevalence and genital HIV viral load in African women

“…A similar trend was found for HIV-1 RNA shedding in the genital tract of HIV-positive women. These findings are in agreement with the majority of studies that have also investigated these associations (Spear et al, 2008;Mitchell et al, 2009;Dols et al, 2011;Pépin et al, 2011;Schellenberg et al, 2011;Dols et al, 2012;Mitchell et al, 2013), but we are the first to report these associations for multiple STI pathogens and to demonstrate a dose-response relationship. It is important to note that the L. crispatus cluster only contained 11 women, and that the temporality of our findings is unclear because our study was cross-sectional.…”

“…A few exploratory studies have described differences between HIV-positive and HIV-negative women, and most found trends toward decreased lactobacilli and increased bacterial diversity (Spear et al, 2008;Mitchell et al, 2009;Dols et al, 2011;Pépin et al, 2011;Schellenberg et al, 2011;Dols et al, 2012;Mitchell et al, 2013).…”

Longitudinal Assessment of Pigtailed Macaque Lower Genital Tract Microbiota by Pyrosequencing Reveals Dissimilarity to the Genital Microbiota of Healthy Humans

“…In contrast, women without BV typically have one to four genera that constitute ‡ 98% of the microbiota. 13,14,16 Interestingly, many of the genera that were found at high levels in the pigtailed macaques are equivalent to those present in women with BV; Sneathia, Prevotella, Porphyromonas, and Atopobium sequences were found in the macaques frequently and are also often found in women with BV. 13,5 However, there were also several notable differences between the genital microbiota in the pigtailed macaques and BV.…”

“…In contrast, women with a Lactobacillus-dominated genital microbiota typically have > 75% Lactobacillus sequences. [13][14][15][16]22 Second, the macaque genital microbiota was relatively polymicrobial, which is a feature not usually found in healthy microbiota in women, but that is common in BV. [13][14][15][16] Thus, the number of genera found in the macaques ranged from a median of 6 to a median of 17.…”

“…13,14 For example, bacteria from the genus Sneathia, in the phylum Fusobacteria, cannot be cultured using current methods, but make up a substantial proportion of the microbiota in some women with BV. 15,16 Furthermore, the type of culture medium used for isolation of genital bacteria can bias the types of cultivatable bacteria found. 17 To avoid possible culture bias, a recent study used Multitag Pyrosequencing (MTPS) of the 16S ribosomal RNA (rRNA) gene to characterize the genital microbiota of rhesus macaques (Macaca mulatta).…”