Prevention of vaginal SHIV transmission in macaques by a live recombinant Lactobacillus

Most HIV transmission in women occurs through the cervicovaginal mucosa, which is coated by a bacterial biofilm including Lactobacillus. This commensal bacterium plays a role in maintaining healthy mucosa and can be genetically engineered to produce anti-viral peptides. Here, we report a 63% reduction in transmission of a chimeric simian/human immunodeficiency virus (SHIV(SF162P3)) after repeated vaginal challenges of macaques treated with Lactobacillus jensenii expressing the HIV-1 entry inhibitor cyanovirin-N. Furthermore, peak viral loads in colonized macaques with breakthrough infection were reduced 6-fold. Colonization and prolonged anti-viral protein secretion by the genetically engineered lactobacilli did not cause any increase in proinflammatory markers. These findings lay the foundation for an accessible and durable approach to reduce heterosexual transmission of HIV in women that is coitally independent, inexpensive, and enhances the natural protective effects of the vaginal microflora.