| Abstract [eng] |
Background and Objectives: The relationship between the composition of the vaginal microbiota, human papillomavirus infection, and cervical precancerous lesions represents a significant contemporary research direction, crucial for advancing the understanding of disease progression mechanisms and for the development of improved prevention and treatment strategies. Recent data suggest that dominance of Lactobacillus crispatus bacteria in the vaginal microbiota may help protect against persistent human papillomavirus infection and promote faster viral clearance. The aim of this study is to review existing scientific data on the interrelationship between vaginal microbiota composition, human papillomavirus infection, and cervical precancerous lesions. To achieve this aim, the following objectives were set: to assess the impact of different vaginal microbiota compositions on human papillomavirus infection persistence and clearance, to determine the significance of this interaction in the development of cervical precancerous lesions, and to summarize current scientific research in order to provide conclusions and recommendations. Methods: A literature review was conducted in the “PubMed” database, analyzing English-language published scientific articles over the past 10 years. The following search terms were used: “vaginal microbiota”, “human papillomavirus infection”, “cervical precancerous lesions”, and “cervical neoplasia”. Seventeen articles were selected for inclusion. The studies’ results and graphical representation were evaluated using Microsoft Excel. Results: Women with Lactobacillus crispatus dominated vaginal microbiota have a statistically significantly lower risk of persistent human papillomavirus infection (p < 0.01). Vaginal microbiota dominated by non-Lactobacillus species or Lactobacillus iners is associated with a 2–3-fold increased risk of high-risk human papillomavirus persistence as well as cervical dysplasia or cancer. Bacterial vaginosis may be linked to a 1.8–3.4-fold higher risk of persistent high-risk human papillomavirus infection and the development of cervical precancerous lesions. Microorganisms such as Gardnerella vaginalis, Prevotella spp., Sneathia spp., Delftia, and Atopobium vaginae have been identified as potential biomarkers indicating an elevated risk of cervical lesion progression. Conclusions: The vaginal microbiota is an important modulatory factor in the pathogenesis of cervical precancerous lesions. A vaginal microbiota dominated by Lactobacillus crispatus correlates with protection against human papillomavirus persistence, and dysbiosis – with an increased risk of progression to cervical precancerous lesions. Keywords: vaginal microbiota, human papillomavirus infection, cervical precancerous lesions, cervical neoplasia. |
