The association between female genital tract microbiome composition and female genital tract antiretroviral drug penetration in HIV-infected women: a pilot study Open Access

Patel, Anar (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/3f462543d?locale=en
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Abstract

Background: The impact of the vaginal microenvironment on genital tract antiretroviral drug penetration is unknown. We sought to characterize the vaginal microbiome of virally-suppressed HIV-infected women and examine the association between the vaginal microbiome and FGT ARV drug concentration. 

 

Methods: We enrolled 58 virally-suppressed HIV-infected women in a single urban HIV clinic in Atlanta, GA between 2015-2016 who were on three ARV regimens with one of the following anchor drugs: ATV, DRV, and RAL. Participants underwent two study visits each for microbiome sampling and cervicovaginal and plasma ARV concentration collection. Microbiome analysis was performed utilizing 16s rRNA sequencing and each sample was characterized by diversity and abundance of Lactobacillus species. We used mixed linear models for bivariate and multivariable models to evaluate the association between microbial community type and FGT ARV drug concentration.

 

Results: Microbial community types were characterized as Lactobacillus dominant (low diversity) and non-Lactobacillus-dominant (high diversity) in 67% and 33% of the women, respectively. Significant clinical characteristics associated with percent change in FGT ARV concentration for any drug type in bivariate analyses included recent sexual activity, cigarette smoking, vaginal pH level, and log plasma ARV concentration. In multivariable analyses controlling for these factors, there was no significant association between microbial community type and FGT ARV concentration.

 

Conclusion: In this single center study of 58 virally-suppressed HIV-infected women on combination ART including either ATV, DRV, and RAL, female genital tract microbiome composition was not found to be significantly associated with change in FGT ARV concentration.

 

Table of Contents

INTRODUCTION……………………………………………………………………………….1

 

BACKGROUND………………………………………………………………………………...5

 

METHODS……………………………………………………………………………………..11

 

RESULTS………………………………………………………………………………………19

 

DISCUSSION…………………………………………………………………………………..22

 

REFERENCES…………………………………………………………………………………28

 

TABLES AND FIGURES……………………………………………………………………...35

 

       TABLE 1…………………………………………………………………………………..35

 

       TABLE 2…………………………………………………………………………………..36

 

       FIGURE 1………………………………………………………………………………….37

 

       TABLE 3…………………………………………………………………………………..38

 

       TABLE 4…………………………………………………………………………………..39

 

       TABLE 5…………………………………………………………………………………..40

 

       TABLE 6…………………………………………………………………………………..41

 

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