The relationship between the vaginal microbiota and the prevalence of Human Papillomavirus in sexually active adolescent girls and young women (16-22) in South Africa
1
Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
2
Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2314
ABSTRACT
INTRODUCTION:
Vaginal microbiota may influence Human papillomavirus (HPV) infection, a major cause of cervical cancer. We investigated associations between vaginal microbiota diversity and composition and infection with any HPV, high-risk (HR) or low-risk (LR) HPV in South African young women.
METHODS:
Secondary data analysis of a retrospective cross-sectional study of AGYW (16–22yrs) from Masiphumelele and Soweto (Nov’13-Dec’14). Outcomes include any HPV, HR-HPV and LR-HPV. Exposure includes vaginal microbiota diversity (alpha: Observed species richness, Shannon and Simpson’s E; beta diversity: bray-curtis dissimilarity PCoA, PERMANOVA), community state types (CSTs, identified via VALENCIA), and differential abundance of bacterial taxa (DeSeq2;LEfSe) from16S rRNA sequencing. Logistic regression was used to estimate odds ratios adjusting for a priori confounders including age, age at first sexual debut and vaginal hygiene practices.
RESULTS:
Among n=168 participants, median age was 18 years (IQR 17-20). 45% had BV (nugent score 7-10) or any STI (Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, Mycoplasma genitalium, or HSV-2). 66% (111/168;95%CI=0.59-0.73), had prevalent HPV, 54% HR-HPV (91/168;95%CI=0.47-0.62), 45% had LR-HPV (75/168;95%CI=0.37-0.52). After adjustment, HPV was not associated with age (aOR=0.99;95%CI=0.79-1.26), age at first sexual debut (aOR=0.80;95%CI=0.59-1.07), or vaginal hygiene practices (aOR=0.65;95%CI=0.20–1.87). Microbiome beta diversity differed between AGYW with any HPV (R²=0.0162;p=0.002) and HR-HPV (R²=0.0193;p=0.003) versus those without infections. AGYW with any HPV infection had lower abundance of Lactobacillus crispatus (log2 fold-change=-0.844;p=0.046) and higher abundance of Gardnerella vaginalis (log2 fold-change=1.333;p=0.014). AGYW with HR-HPV had higher abundance of Sneathia amnii (log2 fold-change=1.041;p=0.009), while no differentially abundant bacterial taxa were observed in AGYW with LR-HPV.
CONCLUSIONS:
Vaginal microbiota diversity and composition were associated with prevalent HPV infection. Anaerobe-rich bacterial communities were associated with HR-HPV positivity and Lactobacillus dominance with absence of HPV infection. Characterisation of the vaginal microbiota could assist in identifying women at high risk of HR-HPV supporting targeted screening and prevention strategies.
Vaginal microbiota may influence Human papillomavirus (HPV) infection, a major cause of cervical cancer. We investigated associations between vaginal microbiota diversity and composition and infection with any HPV, high-risk (HR) or low-risk (LR) HPV in South African young women.
METHODS:
Secondary data analysis of a retrospective cross-sectional study of AGYW (16–22yrs) from Masiphumelele and Soweto (Nov’13-Dec’14). Outcomes include any HPV, HR-HPV and LR-HPV. Exposure includes vaginal microbiota diversity (alpha: Observed species richness, Shannon and Simpson’s E; beta diversity: bray-curtis dissimilarity PCoA, PERMANOVA), community state types (CSTs, identified via VALENCIA), and differential abundance of bacterial taxa (DeSeq2;LEfSe) from16S rRNA sequencing. Logistic regression was used to estimate odds ratios adjusting for a priori confounders including age, age at first sexual debut and vaginal hygiene practices.
RESULTS:
Among n=168 participants, median age was 18 years (IQR 17-20). 45% had BV (nugent score 7-10) or any STI (Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, Mycoplasma genitalium, or HSV-2). 66% (111/168;95%CI=0.59-0.73), had prevalent HPV, 54% HR-HPV (91/168;95%CI=0.47-0.62), 45% had LR-HPV (75/168;95%CI=0.37-0.52). After adjustment, HPV was not associated with age (aOR=0.99;95%CI=0.79-1.26), age at first sexual debut (aOR=0.80;95%CI=0.59-1.07), or vaginal hygiene practices (aOR=0.65;95%CI=0.20–1.87). Microbiome beta diversity differed between AGYW with any HPV (R²=0.0162;p=0.002) and HR-HPV (R²=0.0193;p=0.003) versus those without infections. AGYW with any HPV infection had lower abundance of Lactobacillus crispatus (log2 fold-change=-0.844;p=0.046) and higher abundance of Gardnerella vaginalis (log2 fold-change=1.333;p=0.014). AGYW with HR-HPV had higher abundance of Sneathia amnii (log2 fold-change=1.041;p=0.009), while no differentially abundant bacterial taxa were observed in AGYW with LR-HPV.
CONCLUSIONS:
Vaginal microbiota diversity and composition were associated with prevalent HPV infection. Anaerobe-rich bacterial communities were associated with HR-HPV positivity and Lactobacillus dominance with absence of HPV infection. Characterisation of the vaginal microbiota could assist in identifying women at high risk of HR-HPV supporting targeted screening and prevention strategies.
| eISSN: | 2654-1459 |
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