The cervical microbiome in hispanic populations in Texas and Puerto Rico with and without cervical dysplasia

Within the United States, Hispanic women, especially those in Puerto Rico, face a high incidence of cervical cancer development. The objective of this cross-sectional study was to explore the cervical microbiota of Hispanic women at high risk of developing HPV-induced cervical dysplasia or with cervical dysplasia treated in Texas and Puerto Rico. Cervical swab samples were collected from 296 participants ( N = 80 Texan Non-Hispanic White, N = 98 Texan Hispanic, and N = 118 Puerto Rican Hispanic) during a gynecological exam. DNA was extracted from the swab samples, and the 16 S rRNA V4 hypervariable region was amplified and sequenced using MiSeq for microbiome profiling. Taxonomic species classification was determined using a custom taxonomic classifier trained on a cervicovaginal-specific database. Alpha and beta diversity were computed using QIIME2 and the microeco R package. Participants’ disease status was classified based on cervical phenotype using cytology or histopathology, where available, within 30 days of sample collection. High-risk normal was defined as all patients who presented to the colposcopy clinic due to a history of abnormal cytology or HPV positivity, but with no current dysplasia. Patients classified as dysplasia had low- or high-grade lesions. HPV types were grouped as HPV 16, other high-risk HPV types, and other using HPV genotyping. Among participants, 71% ( N = 211) were classified as high-risk normal, and 29% ( N = 85) had cervical dysplasia. HPV 16 was detected in 15% ( N = 45), other high-risk HPV types in 33% ( N = 98), while 52% ( N = 152) of patients were classified as “other”. Comparative analysis of microbial community structures across locations revealed distinct compositions, with Texan Hispanic women showing higher alpha diversity for two alpha diversity metrics (Pielou evenness and Shannon Diversity Index). The prevalence of CSTs varied across locations and disease states, with CSTs III and IV-B being among the most common in the study cohorts. Overall, this descriptive study provides a better understanding of the cervical microbiome in Hispanic women across multiple geographic locations, in order to guide future interventions.