Vaginal microbiome-hormonal contraceptive interactions associate with the mucosal proteome and HIV acquisition

Alterations to the mucosal environment of the female genital tract, such as genital inflammation, have been associated with increased HIV acquisition in women. As the microbiome and hormonal contraceptives can affect vaginal mucosal immunity, we hypothesized these components may interact in the cont...

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Bibliographic Details
Published in:PLoS pathogens 2020-12, Vol.16 (12), p.e1009097
Main Authors: Noël-Romas, Laura, Perner, Michelle, Molatlhegi, Refilwe, Farr Zuend, Christina, Mabhula, Amanda, Hoger, Sarah, Lamont, Alana, Birse, Kenzie, Berard, Alicia, McCorrister, Stuart, Westmacott, Garett, Leslie, Al, Poliquin, Vanessa, Heffron, Renee, McKinnon, Lyle R, Burgener, Adam D
Format: Article
Language:English
Subjects:
Adult
Bacterial proteins
Biology and Life Sciences
Birth control
Contraceptive Agents, Female - adverse effects
Contraceptive Agents, Hormonal - adverse effects
Contraceptives
Cytokines
Female
Genital tract
Health aspects
Health risks
Hirsch index
HIV
HIV infection
HIV Infections - transmission
Host-bacteria relationships
Human immunodeficiency virus
Humans
Immune response
Immune system
Infections
Inflammation
Mass spectrometry
Mass spectroscopy
Medicin och hälsovetenskap
Medicine and Health Sciences
Microbiomes
Microbiota (Symbiotic organisms)
Microbiota - drug effects
Microorganisms
Middle Aged
Mucosa
Mucous Membrane - drug effects
Mucous Membrane - microbiology
Progesterone
Proteome - drug effects
Proteomes
Risk
Risk factors
Sexual behavior
Sexually transmitted diseases
Statistical analysis
Statistical methods
STD
Transplants & implants
Vagina
Vagina - microbiology
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Summary:Alterations to the mucosal environment of the female genital tract, such as genital inflammation, have been associated with increased HIV acquisition in women. As the microbiome and hormonal contraceptives can affect vaginal mucosal immunity, we hypothesized these components may interact in the context of HIV susceptibility. Using previously published microbiome data from 685 women in the CAPRISA-004 trial, we compared relative risk of HIV acquisition in this cohort who were using injectable depot medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN), and combined oral contraceptives (COC). In women who were Lactobacillus-dominant, HIV acquisition was 3-fold higher in women using DMPA relative to women using NET-EN or COC (OR: 3.27; 95% CI: 1.24-11.24, P = 0.0305). This was not observed in non-Lactobacillus-dominant women (OR: 0.95, 95% CI: 0.44-2.15, P = 0.895) (interaction P = 0.0686). Higher serum MPA levels associated with increased molecular pathways of inflammation in the vaginal mucosal fluid of Lactobacillus-dominant women, but no differences were seen in non-Lactobacillus dominant women. This study provides data suggesting an interaction between the microbiome, hormonal contraceptives, and HIV susceptibility.
ISSN:1553-7374
1553-7366
1553-7374
DOI:10.1371/journal.ppat.1009097