Journal Article

Interplay Between the Temporal Dynamics of the Vaginal Microbiota and Human Papillomavirus Detection

Ravel, Jacques, Gajer, Pawel, Shardell, Michelle D., Tracy, J. Kathleen, Gravitt, Patti E., Zenilman, Jonathan M., Brotman, Rebecca M.

2014

Overview

Background. We sought to describe the temporal relationship between vaginal microbiota and human papillomavirus (HPV) detection. Methods. Thirty-two reproductive-age women self-collected midvaginal swabs twice weekly for 16 weeks (937 samples). Vaginal bacterial communities were characterized by pyrosequencing of barcoded 16S rRNA genes and clustered into 6 community state types (CSTs). Each swab was tested for 37 HPV types. The effects of CSTs on the rate of transition between HPV-negative and HPV-positive states were assessed using continuous-time Markov models. Results. Participants had an average of 29 samples, with HPV point prevalence between 58%-77%. CST was associated with changes in HPV status (P<.001). Lactobacillus gassen-dominated CSTs had the fastest HPV remission rate, and a low Lactobacillus community with high proportions of the genera Atopobium (CST IV-B) had the slowest rate compared to L. crispat ws-dominated CSTs (adjusted transition rate ratio [aTRR], 4.43, 95% confidence interval [CI], 1.11-17.7; aTRR, 0.33, 95% CI, .12-1.19, respectively). The rate ratio of incident HPV for low Lactobacillus CST IV-Awas 1.86 (95% CI, .52-6.74). Conclusions. Vaginal microbiota dominated by L. gasseri was associated with increased clearance of detectable HPV. Frequent longitudinal sampling is necessary for evaluation of the association between HPV detection and dynamic microbiota.

• Publisher: Oxford University Press
• Subject: Adolescent / Adult / Alphapapillomavirus - classification / Alphapapillomavirus - genetics / Alphapapillomavirus - isolation & purification / Bacteria / Bacterial vaginosis / Biological and medical sciences / Cluster Analysis / Female / Fundamental and applied biological sciences. Psychology / Hormonal contraceptives / Human papillomavirus / Humans / Infections / Infectious diseases / Intrauterine devices / Lactobacillus / Longitudinal studies / Major and Brief Reports / Markov Chains / Medical sciences / Metagenome / Microbiology / Microbiota / Middle Aged / Miscellaneous / Papillomavirus Infections - virology / Risk Factors / Sexual intercourse / Vagina - microbiology / Vagina - virology / Vaginosis, Bacterial - microbiology / Vaginosis, Bacterial - virology / Virology / Women / Young Adult