Abstract
Condyloma acuminatum (CA) is one of the most common sexually transmitted diseases, and is characterized by a long incubation period and a high recurrence rate. The vaginal microbiome significantly impacts female reproductive health, influencing susceptibility to human papillomavirus (HPV) infections and related conditions such as CA. However, the role of the vaginal microbiome in the development of CA, especially regarding persistent HPV infection and CA recurrence, remains unclear. We aimed to investigate changes in the vaginal microbiota among female patients with vaginal CA and to determine if disturbances in vaginal flora contribute to persistent HPV infection and CA recurrence. In this study, vaginal swabs were collected from 63 female patients with vaginal CA and 20 healthy females. Furthermore, in the patient cohort, CA patients were stratified into two groups, the HPV persistent-positivity (HPV_PP) group and the HPV turn-negative (HPV_TN) group, based on whether the HPV status converted to negative after a 2-year follow-up. 16S V3-V4 rRNA gene sequencing was performed on these collected samples, followed by a comprehensive analysis of the sequencing data. We performed clinical feature analysis, assessment of the alpha and beta diversity of the vaginal microbiota, comparative analysis of microbial taxa, and functional prediction analysis. We further analyzed the relative abundance and functional profiles between the HPV_PP and HPV_TN groups. The composition and function of the vaginal microflora differed between female patients with vaginal CA and healthy controls, with an increase in alpha diversity observed in the CA group. The relative abundances of P. bivia, Gemella asaccharolytica, Streptococcus agalactiae and Metamycoplasma hominis in the CA group were significantly higher than those in the control group. Moreover, P. bivia and Anaerococcus prevotii were more highly expressed in the HPV_PP group than in the HPV_TN group. With respect to the functional profile, the Kyoto Encyclopedia of Genes and Genomes (KEGG) categories of signal transduction, drug resistance antimicrobial, xenobiotic biodegradation and metabolism, and MAPK signaling pathway, were significantly enriched in the HPV_PP group. In conclusion, the composition and function of the vaginal flora in female patients with vaginal CA are altered, and P. bivia is expected to be a diagnostic biomarker for persistent HPV infection. An imbalance in the vaginal flora is significantly associated with the recurrence of CA and HPV persistent infection.