Cervicovaginal microbiome and virome in discordant HIV shedding

Some women living with HIV (WLHIV) who are on antiretroviral therapy to suppress viral replication nevertheless experience genital HIV shedding (discordant shedding). The microbiome contributes to female genital tract (FGT) health, but little is known about the relationship of the FGT microbiome and virome to discordant HIV shedding and long-term ART. The purpose of this study is to analyze the relationship between the FGT microbiome and virome and discordant HIV shedding during ART. We performed metagenomic sequencing of the bacterial microbiome and virome in cervicovaginal specimens collected longitudinally from WLHIV in Lima, Peru over a two-year period. Characterizing the FGT microbiome and virome during discordant HIV shedding and ART may identify bacteria or viruses implicated in discordant shedding despite HIV suppression in the plasma.