THE ROLE OF THE CERVICOVAGINAL MICROBIOME AND LOCAL IMMUNITY IN HUMAN PAPILLOMAVIRUS PERSISTENCE AND PRECANCEROUS CERVICAL CHANGES

Annotation Background. This study provides a detailed review of the interactions between the cervicovaginal microbiome, local immune responses, and human papillomavirus infection outcomes. Methods. A literature review was conducted covering the period from 2015 to 2024 using the PubMed, Scopus, Embase, and Google Scholar databases. The search included keywords such as human papillomavirus, cervicovaginal microbiome, dysbiosis, cytokines, cervical cancer, Boolean operators, and Medical Subject Headings terms for search refinement.Inclusion criteria: Peer-reviewed publications in English and Russian focusing on the cervicovaginal microbiome, immune responses, human papillomavirus persistence, and cervical neoplasia; observational studies, clinical trials, and reviews. Exclusion criteria: Non-peer-reviewed sources, gray literature, and studies unrelated to microbiome-immune system interactions or human papillomavirus outcomes. Results. Lactobacillus species, particularly L. crispatus, play a key role in maintaining an acidic vaginal environment that modulates local immunity and promotes human papillomavirus clearance. Dysbiosis, characterized by an overgrowth of Gardnerella, Prevotella, and Sneathia, leads to inflammation, disruption of the epithelial barrier, and human papillomavirus persistence. Hormonal fluctuations and environmental factors influence these processes, determining infection outcomes and disease progression. Conclusion. The cervicovaginal microbiome and local immunity are integral to human papillomavirus pathogenesis and cervical cancer prevention.