Exploring the Correlation of Bacterial Vaginosis With Immunoglobulin Profiles in Cervicovaginal Mucus

Abstract

Background: Bacterial Vaginosis (BV) is the most common lower genital tract condition occurring worldwide, with high prevalence in Africa, especially sub-Saharan Africa. BV impacts not only the vaginal microbiome but also poses broader risks to women's reproductive health. BV has been associated with various adverse health outcomes, including an increased risk of sexually transmitted infections (STIs) such as HIV. This study took a novel approach to explore how bacterial vaginosis correlates with immunoglobulin profiles in the cervicovaginal mucus of women aged 18 to 50. The findings from this study offer valuable insights into the immunological mechanisms that contribute to increased HIV susceptibility in the context of BV. Methodology: This exploratory cross-sectional study used stored cervicovaginal mucus samples of women aged 18-50 recruited from KAVI clinics within KNH and Kangemi Health Center. The geometric mean of the MFIs of different samples was calculated and tabulated in Excel. Statistical analysis was performed using GraphPad Prism version (version 8.0.1). We used the Shapiro-Wilk test to check for the normality of our data, which showed that the data was not normally distributed. Therefore, all our statistical tests used non-parametric methods. Results: IgG2 was the most expressed immunoglobulin in the cervicovaginal region, while IgG4 was the least expressed. We found a weak positive correlation between BV, IgA, and IgM. On the other hand, there was a moderate negative correlation between BV and IgG1. Additionally, we observed a trend towards the significance of higher levels of IgG3 in HIV-positive participants compared to HIV-negative participants. Conclusion: Our findings suggest that IgG2 is the most expressed immunoglobulin in the cervicovaginal region, while IgG4 is the least expressed. A weak positive correlation of IgA and IgM towards BV suggests a protective role of IgA and IgM in the immune response to bacterial vaginosis. On the other hand, the moderate negative correlation of IgG1 with BV suggests that BV-associated bacteria (BVAB) might be degrading IgG1 in cervicovaginal mucus. Additionally, we observed a trend towards the significance of higher levels of IgG3 in HIV-positive participants, signifying that IgG3 may have a protective role in viral suppression.