Abstract
BackgroundThe vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables.MethodsIn total 96 women were included in this study. Of these, 26 were single positive for HPV16 in the baseline test and HPV negative in the follow-up test and 38 were single positive for HPV16 in both tests and diagnosed with CIN2+ in histology. In addition, 32 women that were negative for all 12 HPV tested were included. The samples of vaginal fluid were analyzed with the Ion 16S™ Metagenomics Kit and Ion 16S™ metagenomics module within the Ion Reporter™ software.ResultsK-means clustering resulted in two Lactobacillus-dominated groups, one with Lactobacillus sp. and the other specifically with Lactobacillus iners. The two remaining clusters were dominated by a mixed non-Lactobacillus microbiota. HPV negative women had lower prevalence (28%) of the non-Lactobacill dominant cluster in the baseline test, as compared to women with HPV16 infection (42%) (p value = 0.0173). Transition between clusters were more frequent in women with persistent HPV16 infection (34%) as compared in women who cleared the HPV16 infection (19%) (p value = 0.036).ConclusionsThe vaginal microbiota showed a higher rate of transitioning between bacterial profiles in women with persistent HPV16 infection as compared to women with transient infection. This indicate an instability in the microenvironment in women with persistent HPV infection and development of CIN2+.
Highlights
Persistent infection of human papilloma virus (HPV) is the main cause for development of cervical cancer [1]
For the present study we selected 26 women who were single infected by HPV16 in the baseline test and subsequently HPV negative in their follow-up test, and 38 women who were single infected by HPV16 in both the baseline and the follow-up tests, and later diagnosed as CIN2+ based on histology during the follow-up period of 18 months from invitation date
Based on the analysis of all seven variable regions, the analysis identified 723 operational taxonomic units (OTUs), corresponding to 433 species, 188 genera and 102 families
Summary
Persistent infection of human papilloma virus (HPV) is the main cause for development of cervical cancer [1]. In addition to HPV, other risk factors for cervical cancer is recognized, such as smoking, high parity and use of oral contraceptives [4]. The association between HPV infection and the vaginal microbiota is not fully understood. Using 16S sequencing, the vaginal microbiota profiles has previously been described as five community state types (CST). Lactobacillus crispatus, L. gasseri, L. iners and L. jensenii, respectively, while CST IV is dominated by non-Lactobacillus bacteria [5]. The vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables
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