{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:38:09Z","timestamp":1787906289134,"version":"build-2784847793"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Letten Foundation Norway","award":["R01HD083040"],"award-info":[{"award-number":["R01HD083040"]}]},{"name":"Letten Foundation Norway","award":["R01AI128792"],"award-info":[{"award-number":["R01AI128792"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During pregnancy, the vaginal microbiota is relatively stable. However, African women have more diverse vaginal microbiota than their European counterparts, in addition to high human immunodeficiency virus (HIV) prevalence and risk of adverse birth outcomes. Although HIV is associated with alterations in vaginal microbiota and inflammation in nonpregnant women, these relationships are underexplored in pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, we characterize the vaginal microbiota and immune factors in pregnant African women who were HIV-uninfected (n = 314) versus HIV-infected (n = 42). Mucosal samples were collected once at the enrollment visit (between 15 and 35 weeks of gestation) and women were followed until delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Vaginal microbial communities of pregnant women with HIV were significantly more diverse than women without HIV (P = .004), with community structure also differing by HIV status (P = .002, R2 = 0.02). Human immunodeficiency virus infection was also associated with increased risk of preterm birth (PTB) (31% versus 15.3%; P = .066). In a multivariate analysis, HIV infection was independently associated with diverse vaginal community state type (CST)-IVA (P = .005) and CST-IVB (P = .018) as well as PTB (P = .049). No association between HIV status and cytokine concentrations was found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Longitudinal studies with accurate gestational age assessment would be important to confirm these relationships.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiz584","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T15:11:40Z","timestamp":1573485100000},"page":"1194-1203","source":"Crossref","is-referenced-by-count":28,"title":["Human Immunodeficiency Virus Infection Is Associated With Preterm Delivery Independent of Vaginal Microbiota in Pregnant African Women"],"prefix":"10.1093","volume":"221","author":[{"given":"Muchaneta","family":"Gudza-Mugabe","sequence":"first","affiliation":[{"name":"Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa"},{"name":"National Microbiology Reference Laboratory, Harare, Zimbabwe"},{"name":"Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enock","family":"Havyarimana","sequence":"first","affiliation":[{"name":"Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shameem","family":"Jaumdally","sequence":"first","affiliation":[{"name":"Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty Lee","family":"Garson","sequence":"first","affiliation":[{"name":"Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Lennard","sequence":"first","affiliation":[{"name":"Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Tarupiwa","sequence":"first","affiliation":[{"name":"National Microbiology Reference Laboratory, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortunate","family":"Mugabe","sequence":"first","affiliation":[{"name":"Harare Central Hospital, Zimbabwe, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarisai","family":"Marere","sequence":"first","affiliation":[{"name":"College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rooyen T","family":"Mavenyengwa","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, University of Zimbabwe, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindi","family":"Masson","sequence":"first","affiliation":[{"name":"Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather B","family":"Jaspan","sequence":"first","affiliation":[{"name":"Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa"},{"name":"Center for Global Infectious Disease Research, Seattle Children\u2019s Research Institute, Seattle, Washington, USA"},{"name":"Departments of Pediatrics and Global Health, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"2020031610473571300_CIT0001","doi-asserted-by":"crossref","first-page":"8988","DOI":"10.1038\/srep08988","article-title":"The vaginal microbiome during pregnancy and the postpartum period in a European population","volume":"5","author":"MacIntyre","year":"2015","journal-title":"Sci Rep"},{"key":"2020031610473571300_CIT0002","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/s41591-019-0465-8","article-title":"Racioethnic diversity in the dynamics of the vaginal microbiome during pregnancy","volume":"25","author":"Serrano","year":"2019","journal-title":"Nat Med"},{"key":"2020031610473571300_CIT0003","doi-asserted-by":"crossref","DOI":"10.3791\/53939","article-title":"Efficient nucleic acid extraction and 16S rRNA gene sequencing for bacterial community characterization","author":"Anahtar","year":"2016","journal-title":"J Vis Exp"},{"key":"2020031610473571300_CIT0004","doi-asserted-by":"crossref","first-page":"e12078","DOI":"10.1371\/journal.pone.0012078","article-title":"Deep sequencing of the vaginal microbiota of women with HIV","volume":"5","author":"Hummelen","year":"2010","journal-title":"PLoS One"},{"key":"2020031610473571300_CIT0005","first-page":"41","article-title":"Bacterial vaginosis and intravaginal practices: association with HIV","volume":"50","author":"Mbizvo","year":"2004","journal-title":"Cent Afr J Med"},{"key":"2020031610473571300_CIT0006","doi-asserted-by":"crossref","first-page":"287849","DOI":"10.1155\/2012\/287849","article-title":"Pregnancy in HIV-positive patients: effects on vaginal flora","volume":"2012","author":"Vallone","year":"2012","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2020031610473571300_CIT0007","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.bpobgyn.2006.12.005","article-title":"Asymptomatic bacterial vaginosis and intermediate flora as risk factors for adverse pregnancy outcome","volume":"21","author":"Leitich","year":"2007","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2020031610473571300_CIT0008","doi-asserted-by":"crossref","first-page":"226.e1","DOI":"10.1016\/j.ajog.2013.10.003","article-title":"Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort","volume":"210","author":"Foxman","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2020031610473571300_CIT0009","doi-asserted-by":"crossref","DOI":"10.1155\/2010\/521921","article-title":"Mycoplasma, Ureaplasma, and adverse","volume":"2010","author":"Larsen","year":"2010","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2020031610473571300_CIT0010","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/ppe.12106","article-title":"Early pregnancy changes in bacterial vaginosis-associated bacteria and preterm delivery","volume":"28","author":"Nelson","year":"2014","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2020031610473571300_CIT0011","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/2049-2618-2-18","article-title":"The vaginal microbiota of pregnant women who subsequently have spontaneous preterm labor and delivery and those with a normal delivery at term","volume":"2","author":"Romero","year":"2014","journal-title":"Microbiome"},{"key":"2020031610473571300_CIT0012","doi-asserted-by":"crossref","first-page":"356.e1","DOI":"10.1016\/j.ajog.2017.05.030","article-title":"Early pregnancy vaginal microbiome trends and preterm birth","volume":"217","author":"Stout","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"2020031610473571300_CIT0013","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1136\/bmj.39176.674977.AD","article-title":"HIV and pregnancy","volume":"334","author":"Gray","year":"2007","journal-title":"BMJ"},{"key":"2020031610473571300_CIT0014","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1080\/09540121.2011.579948","article-title":"Impact of maternal human immunodeficiency virus infection on pregnancy and birth outcomes in Pune, India","volume":"23","author":"Patil","year":"2011","journal-title":"AIDS Care"},{"key":"2020031610473571300_CIT0015","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/1574-6976.12029","article-title":"Vaginal microbiota and its role in HIV transmission and infection","volume":"37","author":"Petrova","year":"2013","journal-title":"FEMS Microbiol Rev"},{"key":"2020031610473571300_CIT0016","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/00042560-199901010-00008","article-title":"HIV infection and disturbances of vaginal flora during pregnancy","volume":"20","author":"Taha","year":"1999","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"2020031610473571300_CIT0017","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/QAI.0b013e31802ea4b0","article-title":"Pregnancy outcomes in HIV-infected and uninfected women in rural and urban South Africa","volume":"44","author":"Rollins","year":"2007","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020031610473571300_CIT0018","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/QAD.0b013e32834db300","article-title":"Association of HIV infection with spontaneous and iatrogenic preterm delivery: effect of HAART","volume":"26","author":"Lopez","year":"2012","journal-title":"AIDS"},{"key":"2020031610473571300_CIT0019","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1093\/humrep\/des090","article-title":"Maternal HIV infection associated with small-for-gestational age infants but not preterm births: evidence from rural South Africa","volume":"27","author":"Ndirangu","year":"2012","journal-title":"Hum Reprod"},{"key":"2020031610473571300_CIT0020","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1097\/QAD.0b013e32832be0df","article-title":"No relation between in-utero exposure to HAART and intrauterine growth retardation","volume":"23","author":"Briand","year":"2009","journal-title":"AIDS"},{"key":"2020031610473571300_CIT0021","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/QAI.0b013e3181ff04e6","article-title":"Pregnancy outcomes in women exposed to efavirenz and nevirapine: an appraisal of the IeDEA West Africa and ANRS databases, Abidjan, C\u00f4te d\u2019Ivoire","volume":"56","author":"Ekouevi","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020031610473571300_CIT0022","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/QAI.0b013e3181ffa4f5","article-title":"Effects of in utero antiretroviral exposure on longitudinal growth of HIV-exposed uninfected infants in Botswana","volume":"56","author":"Powis","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020031610473571300_CIT0023","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1093\/infdis\/jis553","article-title":"Highly active antiretroviral therapy and adverse birth outcomes among HIV-infected women in Botswana","volume":"206","author":"Chen","year":"2012","journal-title":"J Infect Dis"},{"key":"2020031610473571300_CIT0024","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/sextrans-2017-053506","article-title":"Inflammatory cytokine biomarkers of asymptomatic sexually transmitted infections and vaginal dysbiosis: a multicentre validation study","volume":"95","author":"Masson","year":"2019","journal-title":"Sex Transm Infect"},{"key":"2020031610473571300_CIT0025","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1093\/cid\/civ298","article-title":"Genital inflammation and the risk of HIV acquisition in women","volume":"61","author":"Masson","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2020031610473571300_CIT0026","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/COH.0000000000000232","article-title":"Genital inflammation, immune activation and risk of sexual HIV acquisition","volume":"11","author":"Passmore","year":"2016","journal-title":"Curr Opin HIV AIDS"},{"key":"2020031610473571300_CIT0027","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1038\/cmi.2014.46","article-title":"Immune cells in term and preterm labor","volume":"11","author":"Gomez-Lopez","year":"2014","journal-title":"Cell Mol Immunol"},{"key":"2020031610473571300_CIT0028","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1093\/humrep\/det019","article-title":"Inflammation biomarkers in vaginal fluid and preterm delivery","volume":"28","author":"Taylor","year":"2013","journal-title":"Hum Reprod"},{"key":"2020031610473571300_CIT0029","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/JCM.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J Clin Microbiol"},{"key":"2020031610473571300_CIT0030","doi-asserted-by":"crossref","first-page":"e33865","DOI":"10.1371\/journal.pone.0033865","article-title":"Evaluation of methods for the extraction and purification of DNA from the human microbiome","volume":"7","author":"Yuan","year":"2012","journal-title":"PLoS One"},{"key":"2020031610473571300_CIT0031","article-title":"Microbial composition","volume":"86","author":"Lennard","year":"2017","journal-title":"Infect Immun"},{"key":"2020031610473571300_CIT0032","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1093\/bioinformatics\/btq461","article-title":"Search and clustering orders of magnitude faster than BLAST","volume":"26","author":"Edgar","year":"2010","journal-title":"Bioinformatics"},{"key":"2020031610473571300_CIT0033","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1093\/bioinformatics\/btr381","article-title":"UCHIME improves sensitivity and speed of chimera detection","volume":"27","author":"Edgar","year":"2011","journal-title":"Bioinformatics"},{"key":"2020031610473571300_CIT0034","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1038\/nmeth.f.303","article-title":"QIIME allows analysis of high-throughput community sequencing data","volume":"7","author":"Caporaso","year":"2010","journal-title":"Nat Methods"},{"key":"2020031610473571300_CIT0035","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1111\/j.1654-1103.2003.tb02228.x","article-title":"VEGAN, a package of R functions for community ecology","volume":"14","author":"Dixon","year":"2003","journal-title":"J Veg Sci"},{"key":"2020031610473571300_CIT0036","doi-asserted-by":"crossref","first-page":"W180","DOI":"10.1093\/nar\/gkx295","article-title":"MicrobiomeAnalyst: a web-based tool for comprehensive statistical, visual and meta-analysis of microbiome data","volume":"45","author":"Dhariwal","year":"2017","journal-title":"Nucleic Acids Res"},{"key":"2020031610473571300_CIT0037","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40168-017-0237-y","article-title":"Normalization and microbial differential abundance strategies depend upon data characteristics","volume":"5","author":"Weiss","year":"2017","journal-title":"Microbiome"},{"key":"2020031610473571300_CIT0038","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1038\/ismej.2011.139","article-title":"An improved Greengenes taxonomy with explicit ranks for ecological and evolutionary analyses of bacteria and archaea","volume":"6","author":"McDonald","year":"2012","journal-title":"ISME J"},{"key":"2020031610473571300_CIT0039"},{"key":"2020031610473571300_CIT0040","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1097\/QAD.0000000000001421","article-title":"Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors","volume":"31","author":"Chehoud","year":"2017","journal-title":"AIDS"},{"key":"2020031610473571300_CIT0041","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/QAD.0b013e328012b838","article-title":"Infectious correlates of HIV-1 shedding in the female upper and lower genital tracts","volume":"21","author":"Coleman","year":"2007","journal-title":"AIDS"},{"key":"2020031610473571300_CIT0042","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S1473-3099(18)30061-6","article-title":"Vaginal microbes, inflammation, and HIV risk in African women","volume":"18","author":"Passmore","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2020031610473571300_CIT0043"},{"key":"2020031610473571300_CIT0044"},{"key":"2020031610473571300_CIT0045","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1515\/JPM.2009.026","article-title":"Preterm labor and bacterial vaginosis-associated bacteria among urban women","volume":"37","author":"Nelson","year":"2009","journal-title":"J Perinat Med"},{"key":"2020031610473571300_CIT0046","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1111\/j.1471-0528.2006.01087.x","article-title":"Bacterial vaginosis in a cohort of Danish pregnant women: prevalence and relationship with preterm delivery, low birthweight and perinatal infections","volume":"113","author":"Svare","year":"2006","journal-title":"BJOG"},{"key":"2020031610473571300_CIT0047","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-2393-14-7","article-title":"Correlates","volume":"14","author":"Slyker","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"2020031610473571300_CIT0048","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ijgo.2011.04.008","article-title":"Risk factors for very preterm delivery and delivery of very-small-for-gestational-age infants among HIV-exposed and HIV-unexposed infants in Botswana","volume":"115","author":"Parekh","year":"2011","journal-title":"Int J Gynaecol Obstet"},{"key":"2020031610473571300_CIT0049","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1093\/infdis\/jir307","article-title":"Increased risk of preterm delivery among HIV-infected women randomized to protease versus nucleoside reverse transcriptase inhibitor-based HAART during pregnancy","volume":"204","author":"Powis","year":"2011","journal-title":"J Infect Dis"},{"key":"2020031610473571300_CIT0050","doi-asserted-by":"crossref","first-page":"775","DOI":"10.3851\/IMP1613","article-title":"Antiretroviral therapy in pregnancy: balancing the risk of preterm delivery with prevention of mother-to-child HIV transmission","volume":"15","author":"Townsend","year":"2010","journal-title":"Antivir Ther"},{"key":"2020031610473571300_CIT0051","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1093\/infdis\/jir715","article-title":"Genital tract inflammation during early HIV-1 infection predicts higher plasma viral load set point in women","volume":"205","author":"Roberts","year":"2012","journal-title":"J Infect Dis"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiz584\/30699197\/jiz584.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/221\/7\/1194\/32913651\/jiz584.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jid\/article-pdf\/221\/7\/1194\/32913651\/jiz584.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T15:47:22Z","timestamp":1612280842000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/221\/7\/1194\/5624965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,13]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2020,3,16]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiz584","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4,1]]},"published":{"date-parts":[[2019,11,13]]}}}