Vaginal microbiome and HPV interplay or coincidence?

The vaginal microbiome (VM) is a dynamic, balanced system of microorganisms, which under normal conditions ensures a balance between the physiological lactobacilli - Lactobacillus species and the pathogenic bacterial flora and enables protection against pathogenic microorganisms. VM plays a role in the infection and persistence of the HPV virus in the human vagina, as well as in the subsequent development and progression of cervical intraepithelial lesions. A vaginal pH higher than 5 is associated with a 10-20% increased risk for HPV positivity among women before menopause, i.e. in the reproductive period. There are also contradictory results regarding the correlation of bacterial vaginosis with incidence, prevalence and persistence of HPV infection, as well as with the development of cervical intraepithelial lesions.Many studies show some correlation between HPV infection and cervical changes, but more research is needed to prove this sophisticated relationship between the host, the microbiota and carcinogenesis. The clinical significance would be enormous and would open up the potential for therapeutic strategies including manipulation of the VM and stimulation of microbiota with protective role.