Introduction/Background Persistent HPV infection is a necessary prerequisite for development of cervical intraepithelial neoplasia (CIN) and cervical cancer. Numerous studies have looked at the correlation of vaginal microbiome profile, HPV infection and CIN. We present a cross sectional analysis of vaginal microbiome profiles of women with high-risk HPV infection attending a tertiary colposcopy centre in Singapore.
Methodology After IRB approval and patient consent, vaginal swabs were collected using OMNIgene (OMR-130) kit. DNA was isolated using QIAamp PowerFecal Pro DNA kit. Sequencing library was prepared using Illumina 16Smetagenomics sequencing workflow for the V3 and V4 variable regions of 16S rRNA gene and analyzed using RefSeq RDP database. Statistical analysis was performed using R.
Results A total of 48 women (including 14 postmenopausal) were included in the study. The median age was 37 years. This multiethnic cohort included Chinese (77.1%), Malay (10.4%), Indian (4.2%) and Caucasian (8.3%). The various HPV subtypes isolated were HPV 16/18 (11.4%), HPV others (65.7%) and multiple genotypes (22.9%).
Firmicutes, Actinobacteria and Bacteroidetes were the main phyla noted. Lactobacillus iners was the main species isolated with 16 of the 48 samples belonging to community state type III. Other common species included Gardnerella vaginalis, Atopobium vaginae, Lactobacillus gasseri, Lactobacillus jensenii, and Sneathia sanguinegens. 20 samples were depleted of lactobacilli representing community state IV. The dominant species isolated in HPV16/18 was different for each sample (n = 4) whereas the dominant species in HPV others were Lactobacillus iners (10/23). The dominant species in low grade histology was Lactobacillus iners (7/20) followed by Gardnerella vaginalis (5/20) while the dominant species in high grade histology were Lactobacillus iners (2/4) and Sneathia sanguinegens (2/4).
Conclusion Lactobacillus iners was noted to be the predominant species in the vaginal microbiome of women with high-risk HPV infection.
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