Microbial Composition Predicts Genital Tract Inflammation and Persistent Bacterial Vaginosis in South African Adolescent Females

Young African females are at an 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 females aged 16 to 22 years. Unsupervised clustering of 16S rRNA gene sequences rev...

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Bibliographic Details
Published in:Infection and immunity Vol. 86; no. 1
Main Authors: Lennard, Katie, Dabee, Smritee, Barnabas, Shaun L, Havyarimana, Enock, Blakney, Anna, Jaumdally, Shameem Z, Botha, Gerrit, Mkhize, Nonhlanhla N, Bekker, Linda-Gail, Lewis, David A, Gray, Glenda, Mulder, Nicola, Passmore, Jo-Ann S, Jaspan, Heather B
Format: Journal Article
Language:English
Published: United States 01.01.2018
Subjects:
Adolescent
Female
Genitalia - microbiology
HIV Infections - microbiology
Humans
Inflammation - microbiology
Microbiota - genetics
Reproductive Tract Infections - microbiology
RNA, Ribosomal, 16S - genetics
Vaginosis, Bacterial - microbiology
Young Adult
HIV target cells
female genital tract microbiome
16S RNA
HIV susceptibility
inflammation
vaginal microbiome
ISSN:1098-5522, 1098-5522
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Summary:Young African females are at an 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 females aged 16 to 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, the microbiome compositional subtype and hormonal contraception were significantly associated with genital inflammation. We identified 40 taxa significantly associated with inflammation, including those reported previously ( , , , , and ) as well as several novel taxa (including increased frequencies of bacterial vaginosis-associated bacterium 1 [BVAB1], BVAB2, BVAB3, , , , , , and and decreased frequencies of , , , and ). 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 bacterial vaginosis (BV); this subtype could be predicted with high specificity and sensitivity based on the Nugent score (≥9) or BVAB1 abundance. We propose that women with this BVAB1-dominated subtype may have chronic genital inflammation due to persistent BV, which may place them at a particularly high risk for HIV infection.
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ISSN:1098-5522
1098-5522
DOI:10.1128/IAI.00410-17