Human Papillomavirus (HPV)-The Interplay between Vaginal Microbiota and HPV, along with its Prevention

Human Papillomavirus (HPV) is considered one of the leading causes of cervical cancer and other anogenital malignancies. While most infections are considered short-term, persistent infection with some high-risk strains of HPV, such as HPV-16 and HPV-18, can lead to oncogenesis. This review explores the inter-relationship between HPV and the vaginal microbiota. It focuses on how the microbial imbalance influences viral persistence.

The article is a narrative review for which a narrative literature search was conducted across PubMed, Elsevier, Scopus, and Web of Science for peer-reviewed English language publications (2000-2025). Boolean operators were used, and research was filtered for original studies and meta-analyses covering HPV prevention, diagnosis, molecular pathways, and treatment.

Preventive strategies include vaccinations such as Cervarix and Gardasil that are considered to be the most effective when they are administered between the ages of 9 and 14. A healthy vaginal microbiome is considered to strengthen the immune system and reduce persistence of the virus. Emerging future trends include AI-based screening, multi-omics, and precision therapies.

Regardless of the available interventions, cervical cancer remains a topic of concern in low- and middle-income countries. Oncogenesis is driven by E6 and E7 oncoproteins, which disrupt cell regulation and metabolism. Beyond host immunity, the microbiota composition is a key factor in progression. AI and Personalized treatment strategies can also help in the optimisation of the treatment.

The relationship between the vaginal microbiome and HPV shows that preventive strategies such as probiotics and vaccination may significantly reduce infection risk and cancer progression.