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Human papillomavirus, sexually transmitted infections and cervicovaginal microbiome in the development of premalignant and malignant uterine cervix lesions.

Abstract:

Recently studies have described that the alteration of the vaginal and cervical microbiota could lead to a favorable microenvironment for the development of neoplastic cervical lesions under certain infections. Changes in bacterial communities, pH elevation, bacterial vaginosis and sexually transmitted infections (STIs) can alter the cervicovaginal microenvironment and allow the persistence of microorganisms such as the human papilloma virus (HPV), promoting the development of cervical dysplasia. The present study identified bibliographic evidences of associations between infection with HPV, other STIs, and the vaginocervical microbiome in the development of these lesions. Original sources of the bases were consulted: PubMed, Sciencedirect, Springerlink, without limitation on dates of publication; were used: «Sexually transmitted infections and cervical cancer», «vaginal microbiota, HPV infection and cervical intraepithelial neoplasia», «vaginal and cervical microbiota», «Relationship between cancer and vaginal microbiota». The final sample was 43 publications. Oncogenic HPV has been significantly associated with G. vaginalis (p<0.025), and it has been detected up to 91.9% in women with cervical lesions; showing greater detection in high-grade intraepithelial lesions (LIEAG). Depletion of Lactobacillus and greater microbial diversity facilitate HPV infection and may be involved in viral persistence and cancer development. It is important to detect these microbial associations, which act as cofactors in the development of cancerous lesions, facilitating the persistence of oncogenic HPV infection, and therefore the development of cancer.