Microbial Bioactives
Microbial Bioactives | Online ISSN 2209-2161
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Volume 5 Number 1 2022
REVIEWS (Open Access)
Vaginal Microbiome Dysbiosis, Persistent HPV Infection, and Preterm Birth: Microbial Ecology Linking Cervical Cancer and Reproductive Risk
Anwar Ullah 1*
Microbial Bioactives 5 (1) 1-8 https://doi.org/10.25163/microbbioacts.5110701
Submitted: 20 January 2022 Revised: 16 March 2022 Accepted: 23 March 2022 Published: 25 March 2022
Abstract
Cervical cancer and preterm birth continue to impose a substantial burden on global reproductive health, yet the biological pathways connecting these seemingly distinct conditions are only beginning to come into focus. Increasingly, the vaginal microbiome appears to sit at the center of this relationship. This narrative review synthesizes current evidence regarding how microbial community structure influences persistent high-risk human papillomavirus (hrHPV) infection, cervical neoplastic progression, and adverse pregnancy outcomes. Across the reviewed literature, Lactobacillus-dominant communities—particularly those enriched with Lactobacillus crispatus—were consistently associated with mucosal stability, lower inflammatory activity, and reduced susceptibility to HPV persistence and preterm birth. In contrast, dysbiotic states characterized by anaerobic overgrowth, including Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., and Sneathia spp., were linked to biofilm formation, epithelial disruption, immune dysregulation, and increased reproductive risk. Meta-analytic findings further suggest that high-diversity vaginal microbiota correlate with significantly elevated odds of persistent hrHPV infection and spontaneous preterm birth. Mechanistically, microbial enzymatic activity, altered vaginal pH, inflammatory cytokine release, and disruption of epithelial integrity collectively appear to drive disease progression. Although variability exists among sequencing methodologies and study populations, the overall evidence supports the concept that vaginal microbial ecology plays a clinically meaningful role in women’s reproductive health. Future microbiome-targeted interventions may provide promising preventive and therapeutic opportunities in cervical cancer management and maternal–fetal medicine.
Keywords: Vaginal microbiome; cervical cancer; preterm birth; HPV persistence; bacterial vaginosis; Lactobacillus; reproductive health
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