Association Between High-Risk Human Papillomavirus Infection and Vaginal Microbiota Dysbiosis Among Women

Background: Cervical cancer is still one of the major causes of cancer-related deaths among women in India. It is caused by a persistent infection with a high-risk human papillomavirus (HR-HPV) type, influenced by dysbiosis. Identifying the HPV genotypes is the primary step in accurately assessing risk and developing targeted prevention and control strategies. As the HPV vaccine is not a complete protection against all HPV strains that may cause cervical cancer, regular screening is still ​‍​‌‍​‍‌​‍​‌‍​‍‌necessary. Materials and Methods: A cross-sectional study done at a hospital included 150 women of reproductive age presenting with abnormal vaginal discharge. Demographic and reproductive information were collected. Vaginal swabs were analyzed for microbiota using culture and 16S rRNA Illumina MiSeq sequencing. Cervical swabs were collected using a liquid-based cytology (LBC) kit for HPV genotyping and cytology. Statistical analysis was performed using t tests, χ² tests, and k-means cluster analysis; P <0.05 was considered statistically significant. Results: The prevalence of HR-HPV was 13.33% among women; 3 samples showed multiple-genotype infection. The mean age of women was 39.66 years. The most frequently detected genotypes were HPV 68 and 59. HPV-positive and HSIL samples exhibited increased microbial diversity, including enrichment of anaerobic bacteria such as Gardnerella, Prevotella, and Dialister . Conclusions: In this hospital-based sample of symptomatic women, vaginal dysbiosis was associated with HR-HPV infection, although this finding is limited by the small number of HPV-positive cases. Whether restoring a healthy vaginal microbiota, in combination with genotype-specific HPV vaccination, could reduce the burden of HPV-related disease remains to be tested. Longitudinal and genotype-specific analytical studies are needed to elucidate causal mechanisms and regional variations.