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Abstract
In this study, we evaluated the association between high-risk human papillomavirus (hrHPV) and the vaginal microbiome. Participants were recruited in Nigeria between April and August 2012. Vaginal bacterial composition was characterized by deep sequencing of barcoded 16S rRNA gene fragments (V4) on Illumina MiSeq and HPV was identified using the Roche Linear Array® HPV genotyping test. We used exact logistic regression models to evaluate the association between community state types (CSTs) of vaginal microbiota and hrHPV infection, weighted UniFrac distances to compare the vaginal microbiota of individuals with prevalent hrHPV to those without prevalent hrHPV infection, and the Linear Discriminant Analysis effect size (LEfSe) algorithm to characterize bacteria associated with prevalent hrHPV infection. We observed four CSTs: CST IV-B with a low relative abundance of Lactobacillus spp. in 50% of participants; CST III (dominated by L. iners) in 39·2%; CST I (dominated by L. crispatus) in 7·9%; and CST VI (dominated by proteobacteria) in 2·9% of participants. LEfSe analysis suggested an association between prevalent hrHPV infection and a decreased abundance of Lactobacillus sp. with increased abundance of anaerobes particularly of the genera Prevotella and Leptotrichia in HIV-negative women (P < 0·05). These results are hypothesis generating and further studies are required.
Highlights
In model A, we examined the association between vaginal community state types (CSTs) and prevalent high-risk human papillomavirus (hrHPV) infection using an exact logistic regression model, and in model B, we used exact logistic regression to examine the association between each CST and prevalent hrHPV infection by dichotomizing the CSTs into a CST of interest and all other CSTs combined
Women with hrHPV infection were more likely to have had 412 years of education compared to hrHPV-negative women (P = 0·01) (Table 1). hrHPV-positive women were slightly younger with mean (S.D.) age of 34·2 (7·3) years compared to hrHPV-negative women [37·9 (7·8) years] (P = 0·001)
Because HIV has previously been shown to be associated with disruptions in the vaginal microbiota, which could be explained by suppressed immune system associated with the disease, and may remain even in HIV-positive persons on combination antiretroviral therapy [52, 53], we evaluated the association between vaginal CST and HIV status in our study
Summary
The study population for this analysis has been previously described [32, 33]. 278 women were recruited in Abuja, Nigeria between April and August 2012. Trained nurses administered questionnaires to collect information on socio-demographic characteristics and other risk factors. They conducted detailed gynaecological examinations and collected biological specimens. Mid-vaginal swabs and exfoliated ectocervical cells were collected from all participants using the Elution Swab system (Copan, Italy) and stored in 1 ml Amies’ Transport media (Copan) using common clinical practices. The swabs were immediately frozen and stored at −80 °C until shipped to the University Of Maryland School Of Medicine, Institute for Genome Sciences where they were
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