Department of Obstetrics and Gynecology, 198113University of British Columbia, Vancouver, BC, Canada.
469220Canadian HIV Trials Network, Vancouver, BC, Canada.
Int J STD AIDS. 2022 Aug;33(9):847-855. doi: 10.1177/09564624221109686. Epub 2022 Jul 1.
Women living with HIV (WLWH) experience higher rates of human papillomavirus (HPV) infection and cervical cancer than women without HIV. Changes in the vaginal microbiome have been implicated in HPV-related disease processes such as persistence of high-risk HPV infection but this has not been well defined in a population living with HIV.
Four hundred and 20 girls and WLWH, age ≥9, across 14 clinical sites in Canada were enrolled to receive three doses of quadrivalent HPV vaccine for assessment of vaccine immunogenicity. Blood, cervical cytology, and cervico-vaginal swabs were collected. Cervico-vaginal samples were tested for HPV DNA and underwent microbiota sequencing.
Principal component analysis (PCA) and hierarchical clustering generated community state types (CSTs). Relationships between taxa and CSTs with HPV infection were examined using mixed-effects logistic regressions, Poisson regressions, or generalized linear mixed-effects models, as appropriate. Three hundred and fifty-six cervico-vaginal microbiota samples from 172 women were sequenced. Human papillomavirus DNA was detected in 211 (59%) samples; 110 (31%) contained oncogenic HPV. Sixty-five samples (18%) were taken concurrently with incident oncogenic HPV infection and 56 (16%) were collected from women with concurrent persistent oncogenic HPV infection.
No significant associations between taxa, CST, or microbial diversity and HPV-related outcomes were found. However, we observed weak associations between a dysbiotic microbiome and specific species, including , , and species, with incident HPV infection.
与未感染 HIV 的女性相比，感染人类免疫缺陷病毒（HIV）的女性（WLWH）经历更高的人乳头瘤病毒（HPV）感染和宫颈癌发病率。阴道微生物群的变化与 HPV 相关的疾病过程有关，例如高危 HPV 感染的持续存在，但在感染 HIV 的人群中，这一点尚未得到很好的定义。
在加拿大的 14 个临床地点，招募了 420 名年龄≥9 岁的女孩和 WLWH，以接受三剂四价 HPV 疫苗，以评估疫苗的免疫原性。采集血液、宫颈细胞学和宫颈阴道拭子。对宫颈阴道样本进行 HPV DNA 检测，并进行微生物组测序。
主成分分析（PCA）和层次聚类生成了社区状态类型（CSTs）。使用混合效应逻辑回归、泊松回归或广义线性混合效应模型，适当检查分类群与 CST 与 HPV 感染之间的关系。对来自 172 名女性的 356 个宫颈阴道微生物组样本进行了测序。在 211 个（59%）样本中检测到 HPV DNA；110 个（31%）包含致癌 HPV。65 个样本（18%）与新发生的致癌 HPV 感染同时采集，56 个样本（16%）来自同时存在持续性致癌 HPV 感染的女性。
未发现分类群、CST 或微生物多样性与 HPV 相关结局之间存在显著关联。然而，我们观察到微生态失调与特定物种之间存在微弱关联，包括、、和 种，与新发生的 HPV 感染有关。
