Implementing research programs to characterize the human microbiome and its role in health and disease is a major focus in our Division. We are studying the correlates of viral persistence in the causal pathway of cervical cancer. Recently, we documented the complexity of vaginal microbiome and classified consistent microbial groupings that provided new insight into relationship between the vaginal microbiome and cervical cancer pathogenesis.

Our team is also investigating the molecular epidemiology of human papillomavirus (HPV) and HIV infection in the pathogenesis of anogenital cancers in MSM. Bacteria in the rectal mucosa may be altered during HIV infection resulting in a compromised local innate immunity and poor activation of a cell mediated immune response. Cell mediated immunity is critical for clearing HPV infections. We are examining whether an altered rectal microbiome during HIV infection contributes to the persistence of high-risk HPV infections, potentially increasing the risk of progression towards anal cancer.

With improved PMTCT globally, greater attention is being focused on HIV-exposed but uninfected infants, who may be different than HIV-unexposed infants with respect to immune responses, longitudinal growth, and clinical outcomes. With 15% of all newborn babies in sub-Saharan Africa exposed to HIV but uninfected, differences in outcomes related to HIV exposure could confer substantial public health consequences. We are currently investigating the role of the infant gut microbiome in developmental delays of HIV-exposed but uninfected infants.

Our team is studying the association of maternal factors, specifically the maternal vagina, skin and breastmilk microbiota, on the development of infant gut microbiome, which may result in altered gut permeability, subnormal growth or weight gain, or excess mortality risk in the children.