Department of Health Behavior and Policy and Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Department of Family Medicine and Population Health, Division of Epidemiology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
J Womens Health (Larchmt). 2023 May;32(5):553-560. doi: 10.1089/jwh.2022.0309. Epub 2023 Mar 10.
The vaginal microbiome (VMB) plays an important role in the persistence of human papillomavirus (HPV) infection and differs by race and among women with cervical intraepithelial neoplasia (CIN). We explored these relationships using 16S rRNA VMB taxonomic profiles of 3050 predominantly Black women. VMB profiles were assigned to three subgroups based on taxonomic markers indicative of vaginal wellness: optimal (, , and ), moderate (), and suboptimal (, , , and others). Multivariable Firth logistic regression models were adjusted for age, smoking, VMB, HPV, and pregnancy status. VMB prevalence by subgroup was 18%, 30%, and 51% for the optimal, moderate, and suboptimal groups, respectively. In fully adjusted models, the risk of CIN grade 3 (CIN3) among non-Latina (nL) Blacks was twice that of nL Whites (odds ratio [OR] = 2.0, 95% confidence interval [CI]: 1.1, 3.9, = 0.02). The VMB modified this association ( = 0.04) such that the risk of CIN3 was significantly higher for nL Blacks than for nL Whites only among women with optimal VMBs (OR = 7.8, 95% CI: 1.7, 74.5, = 0.007). Within racial groups, the risk of CIN3 was only elevated among nL White women with suboptimal VMBs (OR = 6.0, 95% CI: 1.3, 56.9, = 0.02) compared with their racial counterparts with optimal VMBs. Our findings suggest that race is a modifier of the VMB in HPV carcinogenesis. An optimal VMB does not appear to be protective for nL Black women compared with nL White women.
阴道微生物组（VMB）在人类乳头瘤病毒（HPV）感染的持续存在中起着重要作用，并且因种族和宫颈上皮内瘤变（CIN）女性而有所不同。我们使用 3050 名主要是黑人女性的 16S rRNA VMB 分类群谱探索了这些关系。根据阴道健康的分类标记，将 VMB 谱分为三个亚组：最佳（、和）、中度（）和次优（、、和其他）。多变量费希尔逻辑回归模型根据年龄、吸烟、VMB、HPV 和妊娠状况进行了调整。亚组的 VMB 患病率分别为最佳组、中度组和次优组的 18%、30%和 51%。在完全调整的模型中，非拉丁裔（nL）黑人的 CIN3 级（CIN3）风险是 nL 白人的两倍（比值比 [OR] = 2.0，95%置信区间 [CI]：1.1，3.9， = 0.02）。VMB 修饰了这种关联（ = 0.04），使得 nL 黑人中 CIN3 的风险仅在 VMB 最佳的女性中明显高于 nL 白人（OR = 7.8，95%CI：1.7，74.5， = 0.007）。在种族群体内，只有 nL 白人女性的 VMB 次优（OR = 6.0，95%CI：1.3，56.9， = 0.02）与具有最佳 VMB 的种族女性相比，CIN3 的风险才会升高。我们的研究结果表明，种族是 HPV 致癌作用中 VMB 的修饰因子。与 nL 白人女性相比，最佳 VMB 似乎对 nL 黑人女性没有保护作用。
