English

N Kiama Teresa,M Mbugua Paul,Verhelst Rita,Vaneechoutte Mario,Temmerman Marleen,Verstraelen Hans,Estambale Benson

doi:10.5897/ajb2013.13037

Abstract

Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. The current study set out to identify and compare culture isolates of vaginal microflora of human immunodeficiency virus (HIV) positive (HIV+) and HIV negative (HIV-) women at different phases during menstrual cycle from a sub-urban population of Kenya. Seventy four (74) women, 41 HIV+ and 33 HIV-, followed up two consecutive menstrual cycles, had high vaginal swabs taken to prepare Gram stains for six visits and anaerobic cultures for four. All 751 isolates identified by t-DNA polymerase chain reaction (PCR) belong to 51 species. Species cultured more frequently in HIV+ participants were: Lactobacillus jensenii (p=0.01), Lactobacillus iners (p=0.02), Gardnerella vaginalis (p=0.01) and Peptoniphilus lacrimalis (p=0.01). Species cultured more frequently in HIV- women were Dialister micraerophilus (p=0.02) and Streptococcus agalactiae (p=0.04). Lactobacillus predominating both groups were Lactobacilli crispatus, L. jensenii, L. iners and Lactobacilli vaginalis. Bacterial vaginosis (BV) was equally high in HIV+ and HIV- women. Lactobacillus and BV-associated species were cultured more frequently in HIV+ women. Minor species differences were found. Predominant Lactobacillus in culture were L. crispatus, L. iners, L. jensenii and L. vaginalis. These women had lower concentrations of lactobacilli in vaginal microflora than observed in previous studies of Caucasian women.   Key words: Vaginal microflora, human immunodeficiency virus (HIV), menstrual cycle, t-DNA polymerase chain reaction (PCR), culture, bacterial vaginosis.

Highlights

Perturbation of the healthy vaginal ecosystem, by loss of hydrogen peroxide (H2O2)-producingAbbreviations: bacterial vaginosis (BV), Bacterial vaginosis; STIs, sexually transmitted infections; HIV, human immunodeficiency virus; ART, antiretroviral therapy; pap, papanicolaou; enzymelinked immunosorbent assay (ELISA), enzyme-linked immunosorbent assay; PCR, polymerase chain reaction; SDS, sodium dodecyl sulfate.1076 Afr
The goal of the present study was to investigate the composition of vaginal microflora of non-pregnant premenopausal HIV+ and HIV- women in a sub-urban population of Kenya by PCR-based identification of culture isolates obtained during the follicular and ovulation phases of the normal menstrual cycle
Of the HIV+ participants, 63.4% were married compared to 39.4% HIV- ones (p=0.001)

Summary

Introduction

Perturbation of the healthy vaginal ecosystem, by loss of hydrogen peroxide (H2O2)-producing1076 Afr. High prevalence of BV in sub-Saharan Africa (Sewankambo et al, 1997; Taha et al, 1998; Paxton et al, 1998; Martin et al, 1999; van de Wijgert et al, 2000; Demba et al, 2005; Morison et al, 2005; Bukusi et al, 2006; McClelland et al, 2009) has become an issue of global concern It is estimated, for instance, that in endemic areas, nearly one-third of new HIV cases could be prevented if existing BV were cured (Schwebke, 2005). Tackling the HIV burden through eradicating BV and restoring normal vaginal microflora is currently considered part of the most promising answers to the HIV pandemic (Martin et al, 1999; Shin and Kaul, 2008; Bolton et al, 2008)

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