Association of the Vaginal Microbiota with Human Papillomavirus Infection in a Korean Twin Cohort

Abstract

Human papillomavirus (HPV) is the most important causative agent of cervical cancers worldwide. However, ourunderstanding of how the vaginal microbiota might be associated with HPV infection is limited. In addition, the influence ofhuman genetic and physiological factors on the vaginal microbiota is unclear. Studies on twins and their families providethe ideal settings to investigate the complicated nature of human microbiota. This study investigated the vaginalmicrobiota of 68 HPV-infected or uninfected female twins and their families using 454-pyrosequencing analysis targetingthe variable region (V2?V3) of the bacterial 16S rRNA gene. Analysis of the vaginal microbiota from both premenopausalwomen and HPV-discordant twins indicated that HPV-positive women had significantly higher microbial diversity with alower proportion of Lactobacillus spp. than HPV-negative women. Fusobacteria, including Sneathia spp., were identified as apossible microbiological marker associated with HPV infection. The vaginal microbiotas of twin pairs were significantly moresimilar to each other than to those from unrelated individuals. In addition, there were marked significant differences fromthose of their mother, possibly due to differences in menopausal status. Postmenopausal women had a lower proportion ofLactobacillus spp. and a significantly higher microbiota diversity. This study indicated that HPV infection was associated withthe composition of the vaginal microbiota, which is influenced by multiple host factors such as genetics and menopause.The potential biological markers identified in this study could provide insight into HPV pathogenesis and may representbiological targets for diagnostics.