Abstract
Persistent infection with high-risk human papillomavirus (HR-HPV) is an important reason for the progression of cervical intraepithelial neoplasia (CIN). Bacterial vaginosis (BV) is a genital infection that frequently presents in women infected with HPV, but the correlation between BV and HPV during CIN development is still elusive. In this study, we enrolled 624 participants and obtained 423 samples of vaginal secretions from them, including 193 HPV-negative samples and 230 HPV-positive samples. We used 16S rRNA sequencing to measure the vaginal microbiota diversity in women with or without BV and HPV co-infection and then calculated risk factors for CIN progression by logistic regression. We found that condom use (OR=3.480; 95% CI=1.069-11.325; P < .05) was a protective factor against CIN, whereas BV (OR=0.358; 95% CI=0.195-0.656; P < .05) and HR-HPV infection (OR= 0.016; 95% CI=0.004-0.072; P < .001) were risk factors for CIN. BV and HPV infection could trigger an increase in the diversity of vaginal microbiota and decrease Lactobacillus domination, which is conducive to CIN regression. The depletion of the carbohydrate metabolism pathway may induce Lactobacillus reduction. Treating BV in the clinical setting could block CIN development and L. iners may be a crucial species during this process.
Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment