Cervical microbial dysbiosis in single HPV16-positive HSIL

Previous studies on high-grade squamous intraepithelial lesion (HSIL) have typically categorized human papillomavirus (HPV) infection status broadly as positive or negative without distinguishing specific subtypesgenotypes, which may obscure microenvironmental features associated with single HPV16 infection. Therefore, this study characterized the cervical microbiota in 35 single HPV16-positive HSIL women compared to 38 healthy controls using 16S rRNA gene sequencing. The HPV16-positive HSIL group exhibited significant increases in microbial richness and evenness. Compositional alterations included a reduction in Firmicutes and an increase in Fusobacteriota, a decrease in Lactobacillus, and an increase in Sneathia (P < 0.05). Functional prediction revealed significant differences in multiple KEGG pathways and COG functional categories between the two groups (P < 0.05). These findings indicate that single HPV16-positive HSIL is characterized by a dysbiotic microbiota with increased α-diversity, Lactobacillus depletion, and Sneathia enrichment, providing a foundation for exploring these microbes as potential diagnostic biomarkers or therapeutic targets. The mechanisms underlying these changes warrant further investigation.