Male circumcision significantly reduces prevalence and load of genital anaerobic bacteria

Authors

Cindy M. Liu, Translational Genomics Research Institute, Flagstaff, AZFollow
Bruce A. Hungate, Northern Arizona University
Aaron A.R. Tobian, Johns Hopkins University
David Serwadda, Rakai Health Sciences Program, Entebbe, Uganda
Jacques Ravel, University of Maryland, Baltimore
Richard Lester, Translational Genomics Research Institute, Flagstaff, AZ
Godfrey Kigozi, Rakai Health Sciences Program, Entebbe, Uganda
Maliha Aziz, Translational Genomics Research Institute, Flagstaff, AZ
Ronald M. Galiwango, Rakai Health Sciences Program, Entebbe, Uganda
Fred Nalugoda, Rakai Health Sciences Program, Entebbe, Uganda
Tania L. Contente-Cuomo, Translational Genomics Research Institute, Flagstaff, AZ
Maria J. Wawer, Johns Hopkins University
Paul Keim, Northern Arizona University
Ronald H. Gray, Johns Hopkins University
Lance B. Price, George Washington UniversityFollow

Document Type

Journal Article

Publication Date

4-16-2013

Journal

mBio

Volume

Volume 4, Issue 2

Inclusive Pages

e00076-e000713

Abstract

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n= 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men in both study arms had comparable coronal sulcus microbiota; however, by year 1, circumcision decreased the total bacterial load and reduced microbiota biodiversity. Specifically, the prevalence and absolute abundance of 12 anaerobic bacterial taxa decreased significantly in the circumcised men. While aerobic bacterial taxa also increased postcircumcision, these gains were minor. The reduction in anaerobes may partly account for the effects of circumcision on reduced HIV acquisition.

IMPORTANCE The bacterial changes identified in this study may play an important role in the HIV risk reduction conferred by male circumcision. Decreasing the load of specific anaerobes could reduce HIV target cell recruitment to the foreskin. Understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, applicable to populations with high HIV prevalence where male circumcision is culturally less acceptable.

Comments

Reproduced with permission of American Society for Microbiology mBio.

Supplemental figures available here.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

APA Citation

Liu, C.M., Hungate, B.A., Tobian, A.A.R., Serwadda, E., Ravel, J., Lester, R., Kigozi, G., Aziz, M., Galiwango, R.M., Nalugoda, F., Contente-Cuomo, T.K., Wawer, M.J., Keim, P., Gray, R.H., Price, L.B. (2013). Male circumcision significantly reduces prevalence and load of genital anaerobic bacteria. mBio, 4(2), e00076-e000713.

Open Access

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