Disturbance of vaginal microbiocenosis as a cofactor in the development of HPV-associated cervical pathology

The development of cervical intraepithelial neoplasia (CIN) and cervical cancer is significantly associated with long-term persistence of oncogenic strains of human papillomavirus (HPV). Only 10% of cases of HPV infection are characterized by long-term persistence of the virus with the development of CIN, which indicates the presence of cofactors. One of the cofactors in the development of CIN may be vaginal dysbiosis.

Purpose. To study the relationship between disturbances in vaginal microbiocenosis and the presence of HPV-associated cervical lesions.

Material and methods. The study involved 58 women, of whom 3 groups were formed: 1^st (n=18) – patients with CIN I; 2^nd (n=21) – patients with CIN II–III; 3^rd (n=19; control) – patients without neoplastic changes. 4 types of microbiocenosis have been formed: absolute normocenosis; conditional normocenosis; moderate dysbiosis; pronounced dysbiosis.

Results. Vaginal dysbiosis in patients with HPV infection can be considered as a marker, as well as a possible predictor of the development of dysplastic processes in the epithelium of the cervix. A relationship has been identified between disturbances in vaginal microbiocenosis and the presence of HPV-associated cervical lesions, but true cause-and-effect relationships have not been established.

Conclusion. Correction of vaginal microflora can be a decisive event in the elimination of HPV. Future studies should also consider the role of the immune system in the development of CIN.