Impact of vaginal microbiome on HPV clearance and persistence in CIN2-CIN3 women

Background and study aims. Persistent infection by a high-risk oncogenic (cancer-causing) type of Human Papillomaviruses (hrHPV) is related to precancerous lesions and invasive cervical cancer. Cervical cancer still remains one of the most frequent cancers in women worldwide. hrHPV infection is necessary to cause cancer, but other additional factors are needed to be present too. Many factors have been proven to increase the oncogenic ability of hrHPV finally leading to the development of cancer. Among them, in recent years the composition of the vaginal microbiome has been suggested to have a critical role in cervical cancer development, but its role has not yet been made fully clear. Currently, there are no data on the potential importance of the vaginal microbiome in the recovery of patients after surgical removal of cervical cancer. This study aims to assess if specific types of vaginal microbiota are linked to an increased or decreased possibility of recovery after surgical removal of HPV-related cervical cancer. In addition, the vaginal environment will be characterized, to understand if inflammation is an important factor in this process. The results will be helpful in understanding if the vaginal microbiome can have a role in clearing HPV infection or in promoting its persistence. This could possibly pave the way to future treatments based on the use of specific bacteria to restore a protective vaginal microbiome and improving the outcomes of patients with, or at risk of, cervical cancer.