Elena, Krstevska-Kelepurovska and Jasmina, Nikolovska and Angela, Delova and Svetlana, Popovska Kljuseva and Emilija, Jashovic Siveska and Maja, Belevska and Ilija, Kelepurovs (2026) 305 THE VAGINAL MICROBIOME AND HUMAN PAPILLOMAVIRUS INFECTION: FROM LACTOBACILLARY PROTECTION TO DYSBIOSIS AND THERAPEUTIC PROSPECTS. A NARRATIVE REVIEW. KNOWLEDGE - International Journal, 77 (4). pp. 305-309. ISSN 2545-4439 (Online)
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THE+VAGINAL+MICROBIOME+AND+HUMAN+PAPILLOMAVIRUS+INFECTION+FROM+LACTOBACILLARY+PROTECTION+TO+DYSBIOSIS+AND+THERAPEUTIC+PROSPECTS.+A+NARRATIVE+REVIEW.pdf Download (512kB) | Preview |
Abstract
Abstract: The vaginal microbiome has emerged as an important cofactor in the natural history of human
papillomavirus infection and cervical carcinogenesis. Under physiological conditions, the vaginal environment
is dominated by a small number of Lactobacillus species that maintain a low pH through lactic-acid production
and restrain potential pathogens. Loss of this lactobacillary dominance, a state known as dysbiosis, has been
associated with the acquisition, persistence and progression of human papillomavirus infection. This narrative
review summarises the current understanding of this relationship across four themes: the protective mechanisms
of lactobacilli, the features of dysbiosis and its association with infection, the proposed mechanisms linking
dysbiosis and infection and the emerging therapeutic prospects. The evidence consistently shows that a
lactobacilli-dominated state is more frequent in uninfected women, whereas a community rich in anaerobes such
as Gardnerella vaginalis, Prevotella, Atopobium and Sneathia predominates among the infected. The direction
of causation remains unresolved, since dysbiosis may facilitate viral acquisition while the virus may itself
reshape the microbiome, a bidirectional, self-reinforcing relationship is increasingly favoured. The species
Lactobacillus iners occupies an ambiguous position, being associated with both health and transitional states.
Therapeutic restoration of a lactobacilli-dominated community, through probiotics and, more recently, vaginal
microbiota transplantation, represents a promising but still preliminary approach for supporting viral clearanceIt
is recommended that microbiome assessment, including by targeted molecular assays suitable for routine
laboratories, be evaluated for use alongside existing cervical screening and risk-stratification methods, and that
microbiome-directed interventions be examined in controlled studies. The literature was identified through
searches of PubMed and Google Scholar and was limited to peer-reviewed, indexed journals. This review is
intended to provide an integrated synthesis for clinicians and laboratory specialists in the region.
Keywords: vaginal microbiome, human papillomavirus, Lactobacillus species, dysbiosis, probiotics
| Item Type: | Article |
|---|---|
| Subjects: | Scientific Fields (Frascati) > Medical and Health Sciences > Health sciences |
| Divisions: | Higher Medical School |
| Depositing User: | MSc Daniela Petkovska |
| Date Deposited: | 07 Oct 2026 10:54 |
| Last Modified: | 07 Oct 2026 10:54 |
| URI: | https://eprints.uklo.edu.mk/id/eprint/11887 |
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