感染 HIV 的妇女的阴道微生物群与早产风险:范围界定综述》。

IF 2.5 3区 医学 Q3 IMMUNOLOGY American Journal of Reproductive Immunology Pub Date : 2024-10-30 DOI:10.1111/aji.70011
Fouzia Zahid Ali Khan, Saifuddin Ahmed, Anna Maya Powell
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引用次数: 0

摘要

关于感染艾滋病病毒的孕妇(PWLWH)的阴道微生物群(VMB)在妊娠期的作用及其与自发性早产(sPTB)的关系的数据很少。我们进行了一次范围界定综述,以评估感染艾滋病病毒的孕妇阴道微生物群与自发性早产(sPTB)之间的关系。共纳入了三项研究,代表了 652 名孕妇中的 180 名低龄孕妇。所有研究都采用了现代 DNA 测序方法(16S rRNA 扩增、元基因组学或元转录组学)。与未感染 HIV 的孕妇相比,PWLWH 的 VMB 丰富度和多样性更高,在三项研究中的两项研究中,PWLWH 的 sPTB 感染率更高。在乳酸杆菌缺乏、厌氧菌占主导地位的阴道微生物群中,PWLWH 感染 sPTB 的比例较高。在三项研究中的两项研究中,阴道炎症标志物浓度较高与阴道微生物丰富度和多样性增加有关。艾滋病病毒感染状态与 sPTB 存在独立关联。目前还不清楚是PWLWH阴道微生物多样性的增加还是阴道炎症的增加更容易导致PTB,但HIV似乎确实改变了孕妇的VMB,也可能通过与微生物无关的途径影响PTB的发病率。鉴于研究数量有限、样本大小不一、样本收集方法不同以及结果不一致,很难将 HIV、VMB、炎症细胞因子和 sPTB 建立因果关系。
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Vaginal Microbiome and the Risk of Preterm Birth in Women Living With HIV: A Scoping Review

There are sparse data on the role of the vaginal microbiome (VMB) in pregnancy among pregnant women living with HIV (PWLWH) and its association with spontaneous preterm birth (sPTB). We conducted a scoping review to assess associations between vaginal microbiota and sPTB among PWLWH. Three studies were included, representing a total of 180 PWLWH out of 652 total pregnancies. All studies used modern DNA sequencing methods (16S rRNA amplification, metagenomics, or metatranscriptomics). PWLWH had higher VMB richness and diversity compared to HIV-uninfected pregnant women and higher sPTB rates in two of three studies. A higher proportion of sPTB among PWLWH was observed in those with Lactobacillus-deficient, anaerobe-dominant vaginal microbiota. In two of three studies, higher concentrations of vaginal inflammation markers were associated with increased VMB richness and diversity. HIV status was independently associated with sPTB. It is unclear if increased vaginal microbial diversity among PWLWH or increased vaginal inflammation contributes more to PTB, but HIV does appear to alter the VMB in pregnant individuals and may also affect PTB rates in microbiome-independent pathways. Given the limited number of studies, heterogeneity in sample size, sample collection methods, and inconsistent results it is difficult to causally link HIV, VMB, inflammatory cytokines, and sPTB.

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来源期刊
CiteScore
6.20
自引率
5.60%
发文量
314
审稿时长
2 months
期刊介绍: The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.
期刊最新文献
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