Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi
Abstract Lack of Lactobacillus and/or dysbiosis is linked to spontaneous preterm birth (sPTB). The impact of antiretrovirals (ARVs) for HIV treatment or prevention on the vaginal microbiome during pregnancy remains unclear. We examined vaginal microbiome changes in pregnant women in Lilongwe, Malawi...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-04-01
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| Series: | npj Biofilms and Microbiomes |
| Online Access: | https://doi.org/10.1038/s41522-025-00697-8 |
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| author | Friday Saidi Lauren A. Graybill Jennifer H. Tang Twambilile Phanga Beteniko Milala Gabriel Banda Manley Kamija Margaret Kasaro Wilbroad Mutale Joan Price Lameck Chinula Jeffrey Stringer Mina C. Hosseinipour Benjamin H. Chi Jacques Ravel Johanna B. Holm |
| author_facet | Friday Saidi Lauren A. Graybill Jennifer H. Tang Twambilile Phanga Beteniko Milala Gabriel Banda Manley Kamija Margaret Kasaro Wilbroad Mutale Joan Price Lameck Chinula Jeffrey Stringer Mina C. Hosseinipour Benjamin H. Chi Jacques Ravel Johanna B. Holm |
| author_sort | Friday Saidi |
| collection | DOAJ |
| description | Abstract Lack of Lactobacillus and/or dysbiosis is linked to spontaneous preterm birth (sPTB). The impact of antiretrovirals (ARVs) for HIV treatment or prevention on the vaginal microbiome during pregnancy remains unclear. We examined vaginal microbiome changes in pregnant women in Lilongwe, Malawi. Women living with HIV (WLHIV) initiated antiretroviral therapy (ART), while HIV-negative women began oral pre-exposure prophylaxis (PrEP). Of 255 participants (191 HIV-negative, 64 WLHIV) who provided baseline vaginal swabs, 181 provided follow-up swabs one month after ARV initiation. At enrollment, WLHIV had higher Shannon diversity and were more likely to have CST IV-B than CST I or III. After ARV initiation, α-diversity decreased in WLHIV but increased in HIV-negative women. Women initiating PrEP had a lower risk of sPTB compared to WLHIV initiating ART, but transitioning to CST IV during pregnancy increased the odds of sPTB. Larger studies are needed to explore ARV impact on pregnancy outcomes. |
| format | Article |
| id | doaj-art-1ad51a99dc6949e8bea691dcff76174d |
| institution | OA Journals |
| issn | 2055-5008 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Biofilms and Microbiomes |
| spelling | doaj-art-1ad51a99dc6949e8bea691dcff76174d2025-08-20T02:30:20ZengNature Portfolionpj Biofilms and Microbiomes2055-50082025-04-0111111110.1038/s41522-025-00697-8Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in MalawiFriday Saidi0Lauren A. Graybill1Jennifer H. Tang2Twambilile Phanga3Beteniko Milala4Gabriel Banda5Manley Kamija6Margaret Kasaro7Wilbroad Mutale8Joan Price9Lameck Chinula10Jeffrey Stringer11Mina C. Hosseinipour12Benjamin H. Chi13Jacques Ravel14Johanna B. Holm15UNC Project MalawiInstitute for Global Health and Infectious Disease, University of North Carolina at Chapel HillDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel HillUNC Project MalawiUNC Project MalawiUNC Project MalawiUNC Project MalawiDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel HillDepartment of Health Policy and Systems, University of Zambia School of MedicineDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel HillUNC Project MalawiDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel HillUNC Project MalawiDepartment of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel HillInstitute for Genome Sciences, University of Maryland School of MedicineInstitute for Genome Sciences, University of Maryland School of MedicineAbstract Lack of Lactobacillus and/or dysbiosis is linked to spontaneous preterm birth (sPTB). The impact of antiretrovirals (ARVs) for HIV treatment or prevention on the vaginal microbiome during pregnancy remains unclear. We examined vaginal microbiome changes in pregnant women in Lilongwe, Malawi. Women living with HIV (WLHIV) initiated antiretroviral therapy (ART), while HIV-negative women began oral pre-exposure prophylaxis (PrEP). Of 255 participants (191 HIV-negative, 64 WLHIV) who provided baseline vaginal swabs, 181 provided follow-up swabs one month after ARV initiation. At enrollment, WLHIV had higher Shannon diversity and were more likely to have CST IV-B than CST I or III. After ARV initiation, α-diversity decreased in WLHIV but increased in HIV-negative women. Women initiating PrEP had a lower risk of sPTB compared to WLHIV initiating ART, but transitioning to CST IV during pregnancy increased the odds of sPTB. Larger studies are needed to explore ARV impact on pregnancy outcomes.https://doi.org/10.1038/s41522-025-00697-8 |
| spellingShingle | Friday Saidi Lauren A. Graybill Jennifer H. Tang Twambilile Phanga Beteniko Milala Gabriel Banda Manley Kamija Margaret Kasaro Wilbroad Mutale Joan Price Lameck Chinula Jeffrey Stringer Mina C. Hosseinipour Benjamin H. Chi Jacques Ravel Johanna B. Holm Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi npj Biofilms and Microbiomes |
| title | Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi |
| title_full | Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi |
| title_fullStr | Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi |
| title_full_unstemmed | Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi |
| title_short | Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi |
| title_sort | effect of initiation of antiretroviral drugs for hiv prevention or treatment on the vaginal microbiome of pregnant women in malawi |
| url | https://doi.org/10.1038/s41522-025-00697-8 |
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