The vaginal microbiome of pregnant people living with HIV on antiretroviral therapy in the Democratic Republic of Congo: A Pilot Study and Global Meta-analysis.

Microbiota underpin many diseases and/or co-morbidities, and recent studies are revealing that a suboptimal cervicovaginal microbiome (CVMB), including enrichment of anaerobic bacterial vaginosis communities, likely impacts multiple female genital disorders, as well as adverse pregnancy and birth outcomes in pregnant people. Problematically, however, the underlying data to date are biased towards highly developed, Global North countries, which leaves investigating underrepresented Global South populations, such as the Democratic Republic of Congo (DRC), challenging. Here we investigate the CVMB from a cohort of 82 pregnant people living with HIV (PLWH) on antiretroviral therapy (ART) from the DRC and explore the associations between the CVMB (16S amplicon sequencing) and maternal peripheral immune mediators. Additionally, we compare the CVMB of PLWH-ART from DRC to globally available CVMB data (5 studies, 1861 samples) in a meta-analysis to elucidate the impact of HIV on the CVMB.