Effect of initiation of antiretroviral drugs for HIV prevention or treatment on the vaginal microbiome of pregnant women in Malawi
Year: 2025
Type: article
Study design: Observational Study
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.
Source: npj Biofilms and Microbiomes
Language: English
Subfield: Microbiology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $4,290
Awards: G1951574862, G195998185, G2127051194, G2230551448, G459729938, G5839361019, Global Alliance to Prevent Prematurity and Stillbirth - to generate scientific discoveries that will be made readily available to the global community to facilitate more rapid development of equitable an..., Training in Sexually Transmitted Infections and HIV, Integrating multi-omics data: Modeling biomarkers and mechanisms to reduce bacterial vaginosis recurrence, The University of North Carolina Center for AIDS Research, UJMT LAUNCH: Training the next generation of leaders in global health research
OpenAlex ID: W4409838079