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@article{Dabee:2019:10.1371/journal.pone.0213975,
author = {Dabee, S and Barnabas, SL and Lennard, KS and Jaumdally, SZ and Gamieldien, H and Balle, C and Happel, A-U and Murugan, BD and Williamson, A-L and Mkhize, N and Dietrich, J and Lewis, DA and Chiodi, F and Hope, TJ and Shattock, R and Gray, G and Bekker, L-G and Jaspan, HB and Passmore, J-AS},
doi = {10.1371/journal.pone.0213975},
journal = {PLoS One},
title = {Defining characteristics of genital health in South African adolescent girls and young women at high risk for HIV infection.},
url = {http://dx.doi.org/10.1371/journal.pone.0213975},
volume = {14},
year = {2019}
}

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TY  - JOUR
AB  - The genital tract of African women has been shown to differ from what is currently accepted as 'normal', defined by a pH≤4.5 and lactobacilli-dominated microbiota. Adolescent girls and young women (AGYW) from sub-Saharan Africa are at high risk for HIV, and we hypothesized that specific biological factors are likely to be influential. This study aimed to compare characteristics of vaginal health in HIV-negative AGYW (16-22-years-old), from two South African communities, to international norms. We measured plasma hormones, vaginal pH, presence of BV (Nugent scoring), sexually transmitted infections (multiplex PCR for Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, Mycoplasma genitalium) and candidiasis (Gram stain) in AGYW (n = 298) from Cape Town and Soweto. Cervicovaginal microbiota was determined by 16S pyrosequencing; 44 genital cytokines were measured by Luminex; and cervical T-cell activation/proliferation (CCR5, HLA-DR, CD38, Ki67) was measured by multiparametric flow cytometry. 90/298 (30.2%) AGYW were negative for BV, candidiasis and bacterial STIs. L. crispatus and L. iners were the dominant bacteria in cervicovaginal swabs, and the median vaginal pH was 4.7. AGYW with L. crispatus-dominant microbiota (42.4%) generally had the lowest cytokine concentrations compared to women with more diverse microbiota (34/44 significantly upregulated cytokines). Frequencies of CCR5+CD4+ T-cells co-expressing CD38 and HLA-DR correlated positively with interleukin (IL)-6, TNF-α, GRO-α, macrophage inflammatory protein (MIP)-1α, and IL-9. While endogenous oestrogen had an immune-dampening effect on IL-6, TNF-related apoptosis-inducing ligand (TRAIL) and IL-16, injectable hormone contraceptives (DMPA and Net-EN) were associated with significantly lower endogenous hormone concentrations (p<0.0001 for oestrogen and progesterone) and upregulation of 34/44 cytokines. Since genital inflammation and the presence of activated CD4+ T cells i
AU  - Dabee,S
AU  - Barnabas,SL
AU  - Lennard,KS
AU  - Jaumdally,SZ
AU  - Gamieldien,H
AU  - Balle,C
AU  - Happel,A-U
AU  - Murugan,BD
AU  - Williamson,A-L
AU  - Mkhize,N
AU  - Dietrich,J
AU  - Lewis,DA
AU  - Chiodi,F
AU  - Hope,TJ
AU  - Shattock,R
AU  - Gray,G
AU  - Bekker,L-G
AU  - Jaspan,HB
AU  - Passmore,J-AS
DO  - 10.1371/journal.pone.0213975
PY  - 2019///
TI  - Defining characteristics of genital health in South African adolescent girls and young women at high risk for HIV infection.
T2  - PLoS One
UR  - http://dx.doi.org/10.1371/journal.pone.0213975
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30947260
VL  - 14
ER  -

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