Vaginal microbiota and HPV-associated cervical diseases: Established relationship

This review is aimed to analyse research data on the lower genital tract microbiome and factors effecting its composition, as well as the relationship with HPV-associated cervical diseases. Modern studies show that certain types of lactobacilli can play a protective role by reducing the likelihood of human papillomavirus (HPV) infection and contributing to its elimination. At the same time, dysbiotic changes, including decreased levels of lactobacilli and increased levels of opportunistic pathogens, are associated with the development of bacterial vaginosis and other abnormal vaginal biocenosis. These conditions can contribute to the persistence of HPV, increasing the risk of cervical intraepithelial neoplasia and cervical cancer. Most studies show significant differences in the vaginal microbiome composition in women with cervical intraepithelial neoplasia and malignant cervix neoplasms as compared to healthy patients. Anaerobic bacteria such as Gardnerella vaginalis , Mobiluncus spp ., Peptoniphilus spp. , Parvimonas micra, Prevotella spp . that can inhibit the growth of lactobacilli and disrupt the normal balance of microflora play an important role in this process. In addition, decreased levels of Lactobacillus crispatus are associated with a higher probability of HPV persistence and dysplasia progression. Studying mechanisms of interaction between vaginal microbiota and HPV is critically important to understand the mechanisms of pathogenesis of precancerous and malignant processes of the cervix. Further study of these aspects will allow the development of new prevention and treatment strategies to modulate vaginal microflora and reduce the risk of disease progression.