Characterization of the cervicovaginal microbiota and HPV infection persistence in pregnant and non-pregnant Hispanic women living in Puerto Rico

Background: Microbiota that resides in the human body plays a crucial role in development, physiology, immunity, and nutrition. The microbiota of the vagina and the ectocervix serves as a biochemical interface between the host and the environment, being a gatekeeper from foreign microbial invasion and preventing infections. Despite HPV vaccination efforts cervical cancer remains a significant public health problem in Puerto Rico. The characterization of the microbiota in Puerto Ricans has been described previously, however, no study has included the effect of pregnancy and viral infections on the microbiota in this population. Hypothesis During pregnancy, the changes in the hormonal cervicovaginal milieu and the immune response may favor persistence of HPV infections furthering the risk to develop cancer and promote changes in the microbial community composition of the cervicovaginal microbiota. Objective: Characterize cervicovaginal microbiome and identify changes in HPV infection persistence in pregnant and non-pregnant Hispanic women in Puerto Rico Materials and Methods: We conducted a cross-sectional study to characterize the cervicovaginal microbiota in pregnant and non-pregnant women in San Juan, Puerto Rico. Cervical swabs were collected from 345 Hispanic women (n=38 pregnant, n=307 non-pregnant) attending a clinic. Genomic DNA was extracted from these samples using standard human protocols and typed for HPV using the LiPA25 kit. Clinical history and demographic variables were obtained from questionnaires (e.g., BMI, age range, pregnancy status, gestational stage). Genomic DNA underwent sequencing with the Illumina MiSEQ pipeline. QC, alpha, beta analyses and taxonomic profiling were done using QIITA/QIIME pipelines. Results: The expected results for our study is to observe changes in cervicovaginal microbiota composition in terms of Lactobacillus species proportion, richness, and diversity among the pregnant cohort and changes associated with HPV infection status. We found that 71% of the pregnant and 71% of the non-pregnant study participants tested positive for HPV infection. Conclusions and Future Plan: In future we plan to examine association of the cervicovaginal microbiota with pregnancy outcomes (c-section, preterm birth, miscarriage, low birth weight, etc.) and explore the benefits of probiotics that promote a healthy cervicovaginal microbiome over pregnancy outcomes and HPV infectionNIMHD/NIH-1T37MD008636-08; Puerto Rico Science and Technology Trust, Yale University D-CFA