Changes in the amounts and proportions of vaginal Lactobacillus species in Vaginal Discharge Samples from HIV-Positive Women Compared With HIV-Negative Women in Makassar, Indonesia: An Observational Cohort Study

Objective: Changes in number of vaginal microbiota play a role in the pathogenesis of sexually transmitted infections. This study aimed to determine the variations in the number and proportion of Lactobacillus crispatus , Lactobacillus gasseri , Lactobacillus jensenii , and Lactobacillus iners in the vaginal discharge samples of HIV-positive women compared with HIV-negative women in Makassar, Indonesia. Methods: We conducted an observational cohort study at Universitas Hasanuddin Makassar Hospital and Dr. Wahidin Sudirohusodo Central General Hospital, Makassar, Indonesia from June 2023 to September 2023. Vaginal discharge samples were collected from HIV-positive and HIV-negative women, and the amounts of vaginal microbiotas were semi-quantitatively measured by their mRNA level in polymerase chain reaction (PCR) examination. The data on the amounts of vaginal microbiotas were statistically analyzed using the Mann–Whitney U test and Kruskal–Wallis test. Results: Vaginal discharge samples were collected from 42 HIV-positive women and 42 HIV-negative women. There were significant differences in the amounts of Lactobacillus iners in the vaginal discharge samples between HIV-positive and HIV-negative women (median[interquartile range], 3.50 [5.06] vs. 2.29 [5.85] log DNA copies/mL, P < 0.001), as well as in number of Lactobacillus jensenii (0.66 [1.62] vs. 0[0.31] log DNA copies/mL, P = 0.029) and Lactobacillus gasseri (0.87[2.01] vs. 0[0] log DNA copies/ mL, P < 0.001). In contrast, there was no significant difference in the amounts of Lactobacillus crispatus in the vaginal discharge samples between HIV-positive and HIV-negative women (0[0.29] vs. 0[1.08] log DNA copies/mL, P = 0.350). Conclusion: There were increases in the amounts of Lactobacilli microbiome, particularly the L. iners in the vaginal discharge samples from HIV-positive women compared with HIV-negative women. These differences in the microbiota compositions can provide a basis for the development of probiotics based on L. crispatus as an adjunct therapy for the vaginal discharge samples of HIV-positive women.