Role of Vaginal and Gut Microbiota in Human Papillomavirus (HPV) Progression and Cervical Cancer: A Systematic Review of Microbial Diversity and Probiotic Interventions.
- 2025-06-12
- Cureus 17(6)
- PubMed: 40662048
- DOI: 10.7759/cureus.85880
Study Design
- Type
- Review
- Population
- patients with HPV infection, CIN, and cervical cancer
- Methods
- We performed a systematic review to study the relevant literature on gut and cervical microbiota in patients with HPV infection, CIN, and cervical cancer, as well as the role of probiotics in managing these conditions. We searched PubMed, the Cochrane Library, Web of Science, and Google Scholar from their inception to September 2024.
Cervical cancer remains a major global health concern, primarily associated with persistent infection by high-risk human papillomavirus (HrHPV) types. Both gut and vaginal microbiome may influence the progression from HPV infection to cervical intraepithelial neoplasia (CIN) and cervical cancer. We performed a systematic review to study the relevant literature on gut and cervical microbiota in patients with HPV infection, CIN, and cervical cancer, as well as the role of probiotics in managing these conditions. The protocol was registered in the PROSPERO database (#CRD42024584685). We searched PubMed, the Cochrane Library, Web of Science, and Google Scholar from their inception to September 2024. Two reviewers independently checked study eligibility. Both reviewers were responsible for data extraction. Disagreements were resolved by a third senior reviewer. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews. The Joanna Briggs Institute (JBI) checklist was used to assess the risk of bias of the included studies. In total, 82 papers were included in this review. Microbial dysbiosis plays a significant role in HPV infection, its progression, and clearance. The analysis of the microbiome reveals that the transition from HPV infection to CIN to cervical cancer involves a shift from a Lactobacillus-dominated, healthy microbiome to one dominated by pathogenic genera. Women with CIN and cervical cancer demonstrated increased microbial diversity compared to HPV-positive individuals. Pathogenic organisms such as Gardnerella, Prevotella, Sneathia, Streptococcus, and Porphyromonas were more prevalent in the patient population compared to controls. Probiotics were effective in restoring vaginal microbiota and managing HPV clearance, and were also associated with cytological and inflammatory improvement rates. Patients with HPV, CIN, and cervical cancer exhibited a microbial community characterised by an increased abundance of pathogenic genera and reduced levels of beneficial Lactobacillus species. Probiotics could be used as a prophylactic or an adjuvant therapy while treating HPV infection, CIN, and cervical cancer.
Research Insights
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