Bacterial vaginosis among women at high risk for HIV in East Africa: the role of behaviour, host immunity, genetics

在撒哈拉以南非洲，大约有2500万人感染了人类免疫缺陷病毒（HIV），约占全球总数的三分之二。负担最重的是1330万非洲妇女，她们占该地区艾滋病患者的60%。细菌性阴道病（BV）是感染艾滋病毒的一个危险因素，是一种高度流行的生殖道感染，影响妇女。我们不知道BV的原因，也不知道如何长期控制它。通过进一步研究BV的行为、遗传和免疫反应，以及与BV相关的细菌，我们希望进一步了解这些因素在BV中的作用，并建立一个框架，帮助研究人员设计应对这种感染的干预措施。虽然研究表明某些类型的行为是BV的危险因素，特别是阴道内清洁和性行为（例如，新的性伴侣，不使用避孕套的性交频率），但这些行为似乎并不能完全解释以下问题：为什么一些人群的BV患病率始终高于其他人群；为什么有些女性有复发性细菌性阴道炎，而有些则没有；以及为什么有些女性有症状而有些没有。我们希望找到这些问题的答案，以指导今后对BV的研究，以减少生殖健康负担和艾滋病毒传播。

Around 25 million people are infected with the human immunodeficiency virus (HIV) in sub-Saharan Africa - roughly two-thirds of the worldwide total. The greatest burden is shouldered by 13.3 million African women, who make up 60% of the epidemic in this region. A risk factor for HIV, bacterial vaginosis (BV) is a highly prevalent, reproductive tract infection affecting women. We do not understand the causes of BV or how to control it long-term. By further investigating behaviour, genetics, and immunological responses to BV, as well as the bacteria that are associated with BV, we hope to further understand the role of these factors in BV and develop a framework that would help researchers to design interventions to respond to this infection. Though research has shown that some types of behaviour are risk factors for BV, notably intravaginal cleansing and sexual behaviour (e.g. new sex partners, frequency of sexual intercourse without condoms), it seems that behaviour does not completely explain the following questions: why some populations have consistently higher prevalence of BV than others; why some women have recurrent BV and others do not; and why some women have symptoms and others do not. We hope to find answers to these questions that will guide future research on BV with the aim of reducing reproductive health burden and HIV transmission.