Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women
<h4>Background</h4> <p>Hormonal contraception has been associated with a reduced risk of vaginal dysbiosis, which in turn has been associated with reduced prevalence of sexually transmitted infections (STIs), including HIV. Vaginal rings are used or developed as delivery systems f...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Public Library of Science
2018
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| _version_ | 1826288605161586688 |
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| author | Crucitti, T Hardy, L Van De Wijgert, J Agaba, S Buyze, J Kestelyn, E Delvaux, T Mwambarangwe, L De Baetselier, I Jespers, V Ring Plus Study Group, |
| author_facet | Crucitti, T Hardy, L Van De Wijgert, J Agaba, S Buyze, J Kestelyn, E Delvaux, T Mwambarangwe, L De Baetselier, I Jespers, V Ring Plus Study Group, |
| author_sort | Crucitti, T |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Hormonal contraception has been associated with a reduced risk of vaginal dysbiosis, which in turn has been associated with reduced prevalence of sexually transmitted infections (STIs), including HIV. Vaginal rings are used or developed as delivery systems for contraceptive hormones and antimicrobial drugs for STI and HIV prevention or treatment. We hypothesized that a contraceptive vaginal ring (CVR) containing oestrogen enhances a lactobacilli-dominated vaginal microbial community despite biomass accumulation on the CVR's surface.</p> <h4>Methods</h4> <p>We enrolled 120 women for 12 weeks in an open-label NuvaRing® study at Rinda Ubuzima, Kigali, Rwanda. Vaginal and ring microbiota were assessed at baseline and each ring removal visit by Gram stain Nugent scoring (vaginal only), quantitative PCR for Lactobacillus species, Gardnerella vaginalis and Atopobium vaginae, and fluorescent in situ hybridization to visualize cell-adherent bacteria. Ring biomass was measured by crystal violet staining.</p> <h4>Results</h4> <p>Bacterial vaginosis (BV) prevalence was 48% at baseline. The mean Nugent score decreased significantly with ring use. The presence and mean log10 concentrations of Lactobacillus species in vaginal secretions increased significantly whereas those of G. vaginalis and presence of A. vaginae decreased significantly. Biomass accumulated on the CVRs with a species composition mirroring the vaginal microbiota. This ring biomass composition and optical density after crystal violet staining did not change significantly over time.</p> <h4>Conclusions</h4> <p>NuvaRing® promoted lactobacilli-dominated vaginal microbial communities in a population with high baseline BV prevalence despite the fact that biomass accumulated on the rings.</p> |
| first_indexed | 2024-03-07T02:16:14Z |
| format | Journal article |
| id | oxford-uuid:a2523516-d2a7-4b2a-81e1-1683e8298d27 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:16:14Z |
| publishDate | 2018 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:a2523516-d2a7-4b2a-81e1-1683e8298d272022-03-27T02:19:24ZContraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan womenJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a2523516-d2a7-4b2a-81e1-1683e8298d27EnglishSymplectic Elements at OxfordPublic Library of Science2018Crucitti, THardy, LVan De Wijgert, JAgaba, SBuyze, JKestelyn, EDelvaux, TMwambarangwe, LDe Baetselier, IJespers, VRing Plus Study Group, <h4>Background</h4> <p>Hormonal contraception has been associated with a reduced risk of vaginal dysbiosis, which in turn has been associated with reduced prevalence of sexually transmitted infections (STIs), including HIV. Vaginal rings are used or developed as delivery systems for contraceptive hormones and antimicrobial drugs for STI and HIV prevention or treatment. We hypothesized that a contraceptive vaginal ring (CVR) containing oestrogen enhances a lactobacilli-dominated vaginal microbial community despite biomass accumulation on the CVR's surface.</p> <h4>Methods</h4> <p>We enrolled 120 women for 12 weeks in an open-label NuvaRing® study at Rinda Ubuzima, Kigali, Rwanda. Vaginal and ring microbiota were assessed at baseline and each ring removal visit by Gram stain Nugent scoring (vaginal only), quantitative PCR for Lactobacillus species, Gardnerella vaginalis and Atopobium vaginae, and fluorescent in situ hybridization to visualize cell-adherent bacteria. Ring biomass was measured by crystal violet staining.</p> <h4>Results</h4> <p>Bacterial vaginosis (BV) prevalence was 48% at baseline. The mean Nugent score decreased significantly with ring use. The presence and mean log10 concentrations of Lactobacillus species in vaginal secretions increased significantly whereas those of G. vaginalis and presence of A. vaginae decreased significantly. Biomass accumulated on the CVRs with a species composition mirroring the vaginal microbiota. This ring biomass composition and optical density after crystal violet staining did not change significantly over time.</p> <h4>Conclusions</h4> <p>NuvaRing® promoted lactobacilli-dominated vaginal microbial communities in a population with high baseline BV prevalence despite the fact that biomass accumulated on the rings.</p> |
| spellingShingle | Crucitti, T Hardy, L Van De Wijgert, J Agaba, S Buyze, J Kestelyn, E Delvaux, T Mwambarangwe, L De Baetselier, I Jespers, V Ring Plus Study Group, Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title | Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title_full | Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title_fullStr | Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title_full_unstemmed | Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title_short | Contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population: A randomised, open-label longitudinal study in Rwandan women |
| title_sort | contraceptive rings promote vaginal lactobacilli in a high bacterial vaginosis prevalence population a randomised open label longitudinal study in rwandan women |
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