Background The substantial risk for respiratory and invasive infections with Streptococcus pneumoniae (Spn) among people with HIV-1 (PWH) begins with asymptomatic colonization. The frequency of Spn colonization among U.S. adults with and without HIV-1 infection is not well-characterized in the conjugate vaccine era. Methods We determined Spn colonization frequency by culture and specific lytA gene QPCR and microbiota profile by 16S rRNA gene sequencing in nasopharyngeal (NP) and oropharyngeal (OP) DNA from 138 PWH and 93 control adults and associated clinical characteristics. Results The frequencies of Spn colonization among PWH and controls did not differ (11.6% vs 8.6%, respectively; p=0.46) using combined results of culture and PCR, independent of vaccination or behavioral risks. PWH showed altered microbiota composition (i.e., beta-diversity. NP: p=0.0028, OP: p=0.0098), decreased alpha-diversity (NP: p=0.024, OP: p=0.0045), and differences in the relative abundance of multiple bacterial taxa. Spn colonization was associated with altered beta-diversity in the NP (p=0.011), but not OP (p=0.21). Conclusions Despite widespread conjugate vaccine and antiretroviral use, frequencies of Spn colonization among PWH and controls are currently consistent with those reported in the pre-conjugate era. The persistently increased risk of pneumococcal disease despite ART may relate to behavioral and immunologic variables other than colonization.

中文翻译：

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HIV-1 感染者和对照成人中肺炎链球菌和天然微生物群上呼吸道定植的临床和微生物决定因素

背景 HIV-1 感染者 (PWH) 中肺炎链球菌 (Spn) 呼吸道和侵袭性感染的重大风险始于无症状定植。在结合疫苗时代，感染或未感染 HIV-1 的美国成年人中 Spn 定植的频率尚不明确。方法 我们通过培养和特定 lytA 基因 QPCR 确定了 Spn 定植频率，并通过 16S rRNA 基因测序确定了 138 名 PWH 和 93 名对照成人的鼻咽 (NP) 和口咽 (OP) DNA 中的微生物群概况以及相关的临床特征。结果 使用培养和 PCR 的综合结果，PWH 和对照组的 Spn 定植频率没有差异（分别为 11.6% 和 8.6%；p=0.46），与疫苗接种或行为风险无关。 PWH 显示微生物群组成发生改变（即 β 多样性。NP：p=0.0028，OP：p=0.0098），α 多样性降低（NP：p=0.024，OP：p=0.0045），以及相对丰度的差异多个细菌类群。 Spn 定植与 NP 中的 β 多样性改变相关（p=0.011），但与 OP 无关（p=0.21）。结论 尽管广泛使用结合疫苗和抗逆转录病毒药物，但目前感染者和对照组中 Spn 定植的频率与结合前时代报道的一致。尽管接受了抗逆转录病毒治疗，肺炎球菌疾病的风险持续增加可能与定植以外的行为和免疫学变量有关。