A Meta-analysis Of The Correlation Between The Vaginal Microbiomc Composition And High-risk HPV Infection And Cervical Lesions

Objective: Studies have shown a correlation between the composition of the vaginal microbiome,High risk Human papillomavirus infection(HR-HPV),and the progression of cervical lesions.However,many studies have had mixed results.This study comprehensively and systematically evaluated the correlation between a specific cervical-vaginal microbiome composition and HPV infection and cervical lesions through narrative and meta-analysis,in order to provide a new perspective and basis for the treatment of HPV infection and cervical lesions.Method: Searches were conducted through Pub Med,Web of science,Embase and Cochrane databases.Selection criteria were original studies of at least two bacterial Community state types(CSTS),based on molecular techniques capable of identifying bacteria,and reported associations with HPV infection,cervical lesions(cervical dysplasia and/or cervical cancer).In this meta-analysis,the construction of forest maps provided direct evidence of the association between the vaginal microbiome composition of CST I and CST IV with HPV and cervical lesions,with odds ratios and 95% confidence intervals.The bias of inclusion was analyzed by funnel plot.Result:(1)A total of 14 literatures were included.The sample size ranged from 17 to 1029 cases.The included population ranged in age from 18 to64;Two study was cross-sectional and 12 were prospective case-control studies.In terms of quality score,there were 12 medium scores and 2 low scores.(2)Compared with the HR-HPV(-)group,the content of CSTI in the HR-HPV(+)group was lower,so CSTI was a protective factor for the occurrence of HR-HPV(+)(OR=0.52;95%CI:0.31-0.89);The level of CST IV in the HR-HPV(+)group was higher than that in the HR-HPV(-)group,and therefore CST IV was a risk factor for the development of HR-HPV(+)(OR=1.94;95%CI:1.46-2.57).(3)Compared with the normal group,the content of CST IV in the cervical lesion group was higher,so CST IV was a risk factor for cervical lesions(OR=1.87;95%CI:1.36-2.57);The level of CST IV in the cervical lesion group was higher than that in the normal group,so CST IV was a risk factor for the development of cervical lesions(OR=1.87;95%CI:1.36-2.57).Conclusion: CSTI is a protective factor for HPV infection and cervical lesions,while CST IV is a risk factor for HPV infection and cervical lesions.These findings suggest an association between certain bacterial community types in the vaginal microbiome and HPV infection and HPV-related disease.This could help guide treatment options or serve as a biomarker for HPV-related diseases.