陰道細菌は,アフリカの女性におけるHIVテノフォビル微生物殺菌剤の有効性を変化させる
Nichole R Klatt1, Ryan Cheu2, Kenzie Birse3,4
1Department of Pharmaceutics, Washington National Primate Research Center, University of Washington, Seattle, WA, USA. adam.burgener@umanitoba.ca klattnr@uw.edu.
まとめ
陰道細菌は女性におけるHIV予防ゲルの有効性に大きな影響を与えます. ラクトバシルスに優勢な微生物群はテノフォビルゲルの有効性を高め,他の細菌は薬物を枯渇させることでそれを減少させます.
科学分野:
- 微生物学
- 感染症
- 薬理学について
背景:
- 抗レトロウイルス薬によるHIV予防の戦略は,女性では異なる有効性を示しています.
- 微生物殺菌剤の有効性を調節する陰道微生物群の役割は完全に理解されていません.
研究 の 目的:
- 陰道微生物の組成がHIV予防におけるテノフォビル陰道ゲルの有効性をどのように影響するかを調査する.
- 女性における微生物殺菌剤の効能の差異のメカニズムを探る
主な方法:
- CAPRISA 004試験に参加した688人の女性における内微生物の組成の分析
- 微生物群の種類とテノフォビルゲルの有効性,および粘膜の薬物濃度との相関.
- テノフォビールの薬理動力学に対する細菌代謝の影響の評価
主要な成果:
- 2つの優勢の陰道細菌群が特定された: ラクトバチルス優勢と ガーデネレラ・ヴァギナリス/無酸素優勢.
- 乳酸菌が多発した女性のHIV感染率は61%減った. 乳酸菌が多発していない女性のHIV感染率は18%減った.
- ラクトバチルス菌のない女性の粘膜のテノフォビル濃度の低下は,薬物の細菌の枯渇と相関していた.
結論:
- 陰道微生物の組成は,テノフォビルゲルのHIV予防の有効性を有意に調節する.
- ガードネレラ・ヴァジナリスや他の無酸素生物によるテノフォビールの細菌代謝は,薬剤の利用可能性と有効性を低下させる.
- 陰道微生物群の理解は 将来の微生物殺菌戦略の最適化に不可欠です
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