title: Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection.
abstract: BACKGROUND
  We sought to describe the temporal relationship between vaginal microbiota and human papillomavirus (HPV) detection.
  
  
  METHODS
  Thirty-two reproductive-age women self-collected midvaginal swabs twice weekly for 16 weeks (937 samples). Vaginal bacterial communities were characterized by pyrosequencing of barcoded 16S rRNA genes and clustered into 6 community state types (CSTs). Each swab was tested for 37 HPV types. The effects of CSTs on the rate of transition between HPV-negative and HPV-positive states were assessed using continuous-time Markov models.
  
  
  RESULTS
  Participants had an average of 29 samples, with HPV point prevalence between 58%-77%. CST was associated with changes in HPV status (P<.001). Lactobacillus gasseri-dominated CSTs had the fastest HPV remission rate, and a low Lactobacillus community with high proportions of the genera Atopobium (CST IV-B) had the slowest rate compared to L. crispatus-dominated CSTs (adjusted transition rate ratio [aTRR], 4.43, 95% confidence interval [CI], 1.11-17.7; aTRR, 0.33, 95% CI, .12-1.19, respectively). The rate ratio of incident HPV for low Lactobacillus CST IV-A was 1.86 (95% CI, .52-6.74).
  
  
  CONCLUSIONS
  Vaginal microbiota dominated by L. gasseri was associated with increased clearance of detectable HPV. Frequent longitudinal sampling is necessary for evaluation of the association between HPV detection and dynamic microbiota.
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine Institute for Genome Sciences, University of Maryland School of Medicine.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Brotman
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Shardell
authors.affiliation: Institute for Genome Sciences, University of Maryland School of Medicine.
authors.forename: Pawel
authors.initials: P
authors.lastname: Gajer
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine.
authors.forename: J Kathleen
authors.initials: JK
authors.lastname: Tracy
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, Johns Hopkins Bayview Medical Center.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Zenilman
authors.affiliation: Institute for Genome Sciences, University of Maryland School of Medicine Department of Microbiology and Immunology, University of Maryland School of Medicine.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ravel
authors.affiliation: Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland.
authors.forename: Patti E
authors.initials: PE
authors.lastname: Gravitt
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D054892:Metagenome; D064307:Microbiota; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000821:virology*; D012307:Risk Factors; D014621:Vagina / Q000382:microbiology* / Q000821:virology*; D016585:Vaginosis, Bacterial / Q000382:microbiology / Q000821:virology; D055815:Young Adult
keywords: 16S rRNA gene analysis; human papillomavirus (HPV); transition model; vaginal microbiota