Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan

<b>Introduction</b>: Vaginal microbiota has emerged as an important factor influencing human papillomavirus (HPV) persistence and host immunity. While HPV infection is often transient, persistent infections with high-risk HPV genotypes significantly increase the risk of cervical carcinog...

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Main Authors: Kuralay Kongrtay, Kuat Kassymbek, Gulzhanat Aimagambetova, Nazira Kamzayeva, Sanimkul Makhambetova, Makhabbat Galym, Zhanar Abdiyeva, Milan Terzic, Kadisha Nurgaliyeva, Talshyn Ukybassova
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Language:English
Published: MDPI AG 2025-06-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/7/679
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author Kuralay Kongrtay
Kuat Kassymbek
Gulzhanat Aimagambetova
Nazira Kamzayeva
Sanimkul Makhambetova
Makhabbat Galym
Zhanar Abdiyeva
Milan Terzic
Kadisha Nurgaliyeva
Talshyn Ukybassova
author_facet Kuralay Kongrtay
Kuat Kassymbek
Gulzhanat Aimagambetova
Nazira Kamzayeva
Sanimkul Makhambetova
Makhabbat Galym
Zhanar Abdiyeva
Milan Terzic
Kadisha Nurgaliyeva
Talshyn Ukybassova
author_sort Kuralay Kongrtay
collection DOAJ
description <b>Introduction</b>: Vaginal microbiota has emerged as an important factor influencing human papillomavirus (HPV) persistence and host immunity. While HPV infection is often transient, persistent infections with high-risk HPV genotypes significantly increase the risk of cervical carcinogenesis. Thus, this study aims to investigate the association between microflora/sexually transmitted infections (STIs) and HPV infection, with a focus on the prevalence of coinfection and the potential role of genital tract microecological disorders. <b>Methods</b>: A prospective cohort study was conducted at a tertiary care center in Astana, Kazakhstan, between November 2024 and March 2025. A total of 396 non-pregnant women aged 18–45 years were enrolled during routine gynecological screening. Cervical samples were collected for high-risk HPV genotyping and the detection of 11 other vaginal microorganisms using real-time PCR. <b>Results:</b> HPV-positive women were significantly younger and more likely to be single compared to HPV-negative participants. They also had fewer pregnancies and deliveries and were more likely to use barrier contraception. Among STIs, <i>Mycoplasma hominis</i> demonstrated a significant association with HPV infection (adjusted OR = 2.16, 95% CI: 1.15–4.05, <i>p</i> = 0.017). Overall STI presence (adjusted OR = 2.16, <i>p</i> = 0.017) and STI multiplicity (adjusted OR = 1.36 per additional STI, <i>p</i> = 0.017) were also significantly associated with HPV positivity. Correlation analysis revealed a moderate association between <i>Chlamydia trachomatis</i> and <i>Trichomonas vaginalis</i> (ϕ = 0.39, <i>p</i> < 0.001), suggesting shared ecological or transmission pathways. <b>Conclusion:</b> The findings highlight the relevance of specific vaginal pathogens, particularly <i>Mycoplasma hominis,</i> and co-infection patterns in increasing the risk of HPV infection. These results underscore the importance of comprehensive STI screening and microbial profiling in cervical cancer prevention strategies, especially in populations with limited access to HPV vaccination. Further longitudinal and mechanistic studies are warranted to elucidate causal pathways and progression to cervical neoplasia.
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spelling doaj-art-bcc61f3160b64320a73ece1719ae7dc12025-07-25T13:38:15ZengMDPI AGVaccines2076-393X2025-06-0113767910.3390/vaccines13070679Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in KazakhstanKuralay Kongrtay0Kuat Kassymbek1Gulzhanat Aimagambetova2Nazira Kamzayeva3Sanimkul Makhambetova4Makhabbat Galym5Zhanar Abdiyeva6Milan Terzic7Kadisha Nurgaliyeva8Talshyn Ukybassova9Department of Surgery, School of Medicine, Nazarbayev University, Astana 010000, KazakhstanClinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, KazakhstanDepartment of Surgery, School of Medicine, Nazarbayev University, Astana 010000, KazakhstanClinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, KazakhstanClinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, KazakhstanClinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, KazakhstanClinical Academic Department of Laboratory Medicine, Pathology and Genetics, CF “University Medical Center”, Astana 010000, KazakhstanDepartment of Surgery, School of Medicine, Nazarbayev University, Astana 010000, KazakhstanClinical Academic Department of Laboratory Medicine, Pathology and Genetics, CF “University Medical Center”, Astana 010000, KazakhstanClinical Academic Department of Women’s Health, CF “University Medical Center”, Astana 010000, Kazakhstan<b>Introduction</b>: Vaginal microbiota has emerged as an important factor influencing human papillomavirus (HPV) persistence and host immunity. While HPV infection is often transient, persistent infections with high-risk HPV genotypes significantly increase the risk of cervical carcinogenesis. Thus, this study aims to investigate the association between microflora/sexually transmitted infections (STIs) and HPV infection, with a focus on the prevalence of coinfection and the potential role of genital tract microecological disorders. <b>Methods</b>: A prospective cohort study was conducted at a tertiary care center in Astana, Kazakhstan, between November 2024 and March 2025. A total of 396 non-pregnant women aged 18–45 years were enrolled during routine gynecological screening. Cervical samples were collected for high-risk HPV genotyping and the detection of 11 other vaginal microorganisms using real-time PCR. <b>Results:</b> HPV-positive women were significantly younger and more likely to be single compared to HPV-negative participants. They also had fewer pregnancies and deliveries and were more likely to use barrier contraception. Among STIs, <i>Mycoplasma hominis</i> demonstrated a significant association with HPV infection (adjusted OR = 2.16, 95% CI: 1.15–4.05, <i>p</i> = 0.017). Overall STI presence (adjusted OR = 2.16, <i>p</i> = 0.017) and STI multiplicity (adjusted OR = 1.36 per additional STI, <i>p</i> = 0.017) were also significantly associated with HPV positivity. Correlation analysis revealed a moderate association between <i>Chlamydia trachomatis</i> and <i>Trichomonas vaginalis</i> (ϕ = 0.39, <i>p</i> < 0.001), suggesting shared ecological or transmission pathways. <b>Conclusion:</b> The findings highlight the relevance of specific vaginal pathogens, particularly <i>Mycoplasma hominis,</i> and co-infection patterns in increasing the risk of HPV infection. These results underscore the importance of comprehensive STI screening and microbial profiling in cervical cancer prevention strategies, especially in populations with limited access to HPV vaccination. Further longitudinal and mechanistic studies are warranted to elucidate causal pathways and progression to cervical neoplasia.https://www.mdpi.com/2076-393X/13/7/679HPVSTICINCCvaginal microbiotabacterial vaginosis
spellingShingle Kuralay Kongrtay
Kuat Kassymbek
Gulzhanat Aimagambetova
Nazira Kamzayeva
Sanimkul Makhambetova
Makhabbat Galym
Zhanar Abdiyeva
Milan Terzic
Kadisha Nurgaliyeva
Talshyn Ukybassova
Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
Vaccines
HPV
STI
CIN
CC
vaginal microbiota
bacterial vaginosis
title Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
title_full Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
title_fullStr Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
title_full_unstemmed Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
title_short Disrupted Vaginal Microbiota and Increased HPV Infection Risk Among Non-Vaccinated Women: Findings from a Prospective Cohort Study in Kazakhstan
title_sort disrupted vaginal microbiota and increased hpv infection risk among non vaccinated women findings from a prospective cohort study in kazakhstan
topic HPV
STI
CIN
CC
vaginal microbiota
bacterial vaginosis
url https://www.mdpi.com/2076-393X/13/7/679
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