The Effects of Vaginal Virome on Women's Health: A Scoping Review

While research on the vaginal microbiome (VMB) has focused mainly on its bacteriome, the role of viral communities remains largely understudied. Given the vaginal virome's potential influence on disease susceptibility and progression, understanding its exact role in different health outcomes is crucial. The objective of this scoping review was to analyze studies on the vaginal virome's influence on women's health, the virome's interactions with other microbes, assess the limitations of these studies, and highlight gaps to guide future studies and treatments in the field of gynecological health. The review was conducted using previously gathered literature on the impact of the vaginal virome among reproductive-aged women in developed countries. Articles were sourced from Ovid MEDLINE, Embase, and World of Science using the following search string: vaginal virome AND reproductive health OR infections OR pregnancy outcomes. Articles were screened using the PCC framework as follows: influence of the vaginal virome on women's health (Concept) in women aged 18 and older (Population) in developed countries (Context). Of the 352 articles originally identified, 10 studies met the inclusion criteria and were utilized in this scoping review. The vaginal virome contains a diverse array of viruses and bacteriophages that impact human papillomavirus (HPV) infection persistence and subsequent progression to cervical cancer, pregnancy outcomes, and the inflammatory response. In bacterial vaginosis, reductions in Lactobacillus-targeting bacteriophages have the potential to contribute to dysbiosis. Hormonal fluctuations throughout the menstrual cycle influence both bacterial and viral populations, potentially affecting infection susceptibility and overall vaginal health. During pregnancy, higher viral diversity is associated with preterm birth risk, and immune modulation by the virome may impact susceptibility to infections like HPV. Analysis of the included studies indicates the need for continued investigation of the manner in which the vaginal virome interacts with other aspects of the microenvironment to influence women's health. This scoping review highlights the new and emerging role of the vaginal virome in women's health, highlighting its relationship with other microbes and clinical significance. These findings underscore the importance of the vaginal virome in reproductive health, suggesting that further research is needed to better understand its role and guide effective prevention and treatment strategies.