aidsВИЧ-инфекция и иммуносупрессииHIV Infection and Immunosuppressive Disorders2077-9828Baltic Medical Education Center10.22328/2077-9828-2023-15-1-23-31aids-772Research ArticleАНАЛИТИЧЕСКИЕ ОБЗОРЫANALYTICAL REVIEWSНарушение вагинального микробиома и риск заражения ВИЧ-инфекцией у женщинViolation of the vaginal microbiome and the risk of HIV infection in womenhttps://orcid.org/0000-0001-9248-8303ХрянинА. А.KhryaninA. A.

Хрянин Алексей Алексеевич — доктор медицинских наук, профессор кафедры дерматовенерологии и косметологии; президент

630091, Новосибирск, Красный пр., д. 52

630004, Новосибирск, ул. Ленина, д. 55

 

Novosibirsk

khryanin@mail.ruhttps://orcid.org/0000-0003-4391-2889КноррингГ. Ю.KnorringH. Yu.

Кнорринг Герман Юрьевич — кандидат медицинских наук, доцент кафедры терапии, клинической фармакологии и скорой медицинской помощи

127473, Москва, Делегатская ул., д. 1

Moscow

https://orcid.org/0000-0003-4671-7288БочароваВ. К.BocharovaV. K.

Бочарова Валентина Константиновна — врач-ординатор кафедры дерматовенерологии с клиникой

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

St. Petersburg

Новосибирский государственный медицинский университет; Ассоциация акушеров-гинекологов и дерматовенерологовРоссияNovosibirsk State Medical University; Association Obstetricians-Gynecologists and DermatovenerologistsRussian FederationМосковский государственный медико-стоматологический университет имени А. И. ЕвдокимоваРоссияA. I. Evdokimov Moscow State Medical and Dental UniversityRussian FederationПервый Санкт-Петербургский государственный медицинский университет имени академика И. П. ПавловаРоссияPavlov First State Medical University of St. PetersburgRussian Federation2023300420231512331Copyright © Хрянин А.А., Кнорринг Г.Ю., Бочарова В.К., 20232023Хрянин А.А., Кнорринг Г.Ю., Бочарова В.К.Khryanin A.A., Knorring H.Y., Bocharova V.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hiv.bmoc-spb.ru/jour/article/view/772

Женщины представляют собой основную группу населения, являющуюся причиной новых случаев инфицирования ВИЧ и сохранения пандемии ВИЧ-инфекции. В статье представлен обзор современной литературы о факторах и механизмах, с помощью которых вагинальный микробиом может способствовать заражению ВИЧ-инфекцией. Ключевым фактором, определяющим восприимчивость к ВИЧ-инфекции, является состав вагинального микробиома, который может влиять на местную популяцию иммунных клеток и статус воспаления. Микробный состав с низким разнообразием, в котором преобладают Lactobacillus crispatus, не увеличивает риск заражения ВИЧ, а среда с высоким микробным разнообразием, ассоциированным с бактериальным вагинозом, увеличивает риск заражения ВИЧ. Женский репродуктивный тракт обладает уникальной восприимчивостью к вирусной инфекции, поскольку тканеспецифический иммунитет должен вызывать быстрые антимикробные реакции на патогены, сохраняя при этом толерантность к сперматозоидам. Важно отметить, что риск заражения ВИЧ при половых контактах является многофакторным и определяется не только состоянием микробиоты полового тракта женщины, но и состоянием микробиоты партнера, вирусной нагрузкой ВИЧ в крови полового партнера, наличием/отсутствием антиретровирусной терапии у партнера, гормональным фоном и фазой менструального цикла, которые также влияют на состояние микробиоты.

Women are the main population responsible for new HIV infections and the persistence of the HIV pandemic. The article provides a review of the current literature on the factors and mechanisms by which the vaginal microbiome can contribute to HIV infection. A key determinant of susceptibility to HIV infection is the composition of the vaginal microbiome, which can influence the local immune cell population and inflammation status. A low diversity microbial composition dominated by Lactobacillus crispatus does not increase the risk of HIV infection, and a high microbial diversity environment associated with bacterial vaginosis increases the risk of HIV infection. The female reproductive tract has a unique susceptibility to viral infection because tissue-specific immunity must elicit rapid antimicrobial responses to pathogens while maintaining sperm tolerance. It is important to note that the risk of HIV infection during sexual intercourse is multifactorial and is determined not only by the state of the microbiota of a woman’s genital tract, but also by the state of the partner’s microbiota, the viral load of HIV in the blood of the sexual partner, the presence/absence of anti-retroviral therapy in the partner, hormonal background and the phase of the menstrual cycle, which also affect the state of the microbiota.

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The authors declare that there are no conflicts of interest present.