The impact of cervicovaginal microbiome on HPV infection in vaccinated young Korean women.

ObjectiveTo investigate the prevalence of high-risk human papillomavirus (hrHPV) infection and its association with cervicovaginal microbiome (CVM) diversity among young Korean women who received human papillomavirus (HPV) vaccination.MethodsSeventy-two Korean women aged 20-35 years were enrolled in Seoul, South Korea. Cervicovaginal samples were analyzed using liquid-based cytology, HPV genotyping, and 16S rRNA sequencing. Alpha diversity and microbial compositions were compared according to HPV infection and cytology results.ResultsThe prevalence of hrHPV infection was 44.4% (n=32), with HPV 39 and 52 being the most common types. Women with abnormal cytology or hrHPV positivity exhibited significantly higher microbial alpha diversity (Shannon index, p<0.05). bacterial vaginosis-associated bacteria (BVAB) such as Gardnerella leopoldii, G. vaginalis, and Megasphaera lornae were significantly associated with hrHPV positivity, along with Lactobacillus iners showed a strong positive correlation with microbial diversity, abnormal cytology, and hrHPV infection (p<0.001).ConclusionDespite national HPV vaccination, hrHPV infection remains common among young Korean women, primarily driven by non-vaccine types. The dominance of L. iners and enrichment of BVAB were key microbial features associated with hrHPV infection and abnormal cytology, suggesting that ecological imbalance in the CVM may contribute to viral persistence. These findings highlight the potential role of microbiome modulation as a complementary approach in post-vaccination HPV management and prevention.