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. 2024 Mar 13:14:1330844.
doi: 10.3389/fcimb.2024.1330844. eCollection 2024.

Vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program

Anne J M Loonen  1   2 , Femke Verhagen  1 , Ilse Luijten-de Vrije  1 , Marjolein Lentjes-Beer  1 , Cornelis J Huijsmans  1 , Adriaan J C van den Brule  1
Affiliations

Vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program

Anne J M Loonen et al. Front Cell Infect Microbiol. .

Abstract

Human papillomavirus (HPV) is a sexually transmitted virus, which infects approximately 80% of all men and women at some time in their lives. Usually, the infection is resolved successfully by the body's immune system. Persistent infection with high-risk HPV (hrHPV) is necessary but not sufficient for cervical cancer development, and additional factors, such as the vaginal microbiome (vaginome), are thought to be involved. The aim of this study is to investigate whether either vaginal dysbiosis (imbalance in vaginal bacterial composition) or sexually transmitted pathogens, e.g., Chlamydia trachomatis (CT), are possible cofactors for hrHPV infection and HPV-induced cervical dysplasia in asymptomatic women attending the Dutch Cervical Cancer Screening Program. In this study, 492 hrHPV-positive and 500 hrHPV-negative cervical smears from women attending the Screening Program were included. Age and cytology were known for the hrHPV-positive samples. All cervical smears were diluted in Aptima® specimen transfer medium and tested with Aptima® transcription-mediated amplification assays targeting CT, Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Candida spp. (CS), C. glabrata (CG), Trichomonas vaginalis (TV), and bacterial vaginosis (BV). The prevalences of CT, NG, MG, CS, CG, TV, and BV in this cohort were found to be 1.9%, 0.0%, 1.7%, 5.4%, 1.4%, 0.1%, and 27.2%, respectively. When comparing HPV groups, it was found that CT, MG, and BV had a significantly higher prevalence in hrHPV-positive smears as compared with hrHPV-negative samples (for all p < 0.001). No significant differences were found when comparing different age groups and cytology outcomes. In conclusion, vaginal dysbiosis seems associated with hrHPV infection in women attending the Dutch Cervical Cancer Screening Program.

Keywords: Cervical Cancer Screening Program; cervical dysplasia; high risk HPV; vaginal dysbiosis; vaginome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of the study cohort. From hrHPV-positive sample cytology score (Papanicolaou, PAP); the age of the client was registered. From hrHPV-negative cervical smears, only HPV status was documented. High-risk HPV presence was tested in the Cervical Cancer Screening Program (Roche Cobas).
Figure 2
Figure 2
Results of Lactobacillus crispatus-spiked Aptima® Specimen Transfer Medium (left), PreservCyt without SiHa cells (middle), and PreservCyt with 104 SiHa cells (right). The upper graphs represent 100 CFU/mL, and the lower graphs represent 10 CFU/mL. On the x-axis time in minutes and on the y-axis fluorescent signal are depicted. CFU; colony-forming units, IC (green); internal control, Lacto (red) Lactobacillus spp., Gvag (dark blue); Gardnerella vaginalis, Avag (light blue); Atopobium vaginae.
See this image and copyright information in PMC

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