Open AccessVaginal microbiome-hormonal contraceptive interactions associate with the mucosal proteome and HIV acquisition
Author(s) -
Laura NoëlRomas,
Michelle Perner,
Refilwe P. Molatlhegi,
Christina Farr Zuend,
Amanda Mabhula,
Sarah Hoger,
Alana Lamont,
Kenzie Birse,
Alicia R. Berard,
Stuart McCorrister,
Garett Westmacott,
Al Leslie,
Vanessa Poliquin,
Renee Heffron,
Lyle R. McKin,
Adam Burgener
Publication year - 2020
Publication title -
plos pathogens
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.719
H-Index - 206
eISSN - 1553-7374
pISSN - 1553-7366
DOI - 10.1371/journal.ppat.1009097
Subject(s) - medroxyprogesterone acetate , lactobacillus , microbiome , context (archaeology) , bacterial vaginosis , medicine , physiology , hormonal contraception , vagina , immunology , population , hormone , gynecology , obstetrics , family planning , biology , bioinformatics , paleontology , environmental health , bacteria , research methodology , genetics , surgery
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.