The Role of Vaginal Lactobacilli in Cervical Cytological Outcomes among HPV-Infected Women in Niger State, Nigeria

Abstract

Despite growing recognition of the interaction between vaginal microbiota and HPV pathogenesis, data from sub-Saharan Africa remain limited, and findings from other populations may not fully apply due to sociocultural, environmental, and genetic differences influencing vaginal microbial communities. This study investigated the role of vaginal Lactobacilli in influencing cervical cytological outcomes among HPV-infected women in Niger State, Nigeria. A total of 32 women who tested positive for HPV via PCR were assessed for cervical abnormalities using Papanicolaou (PAP) smear, while vaginal swab samples were cultured on de Man, Rogosa and Sharpe (MRS) agar to isolate Lactobacilli, with growth categorized as none, scanty, moderate, or heavy. Results revealed that 68.8% of HPV-positive women had normal cytology, 12.5% had atypical squamous cells of undetermined significance (ASCUS), 12.5% had low-grade squamous intraepithelial lesions (LGSIL), and 6.3% showed inflammation. Notably, half of the participants had no detectable Lactobacilli growth. Statistical analysis showed a significant association between HPV infection and cytological abnormalities (χ² = 19.907, p < 0.001), and between Lactobacilli abundance and cervical cytology (χ² = 20.913, p < 0.001). Higher Lactobacilli levels were predominantly found in women with normal cytology, while absent or scanty growth was associated with abnormal findings. These results underscore the protective role of vaginal Lactobacilli in modulating HPV-related cervical epithelial changes and highlight the need to incorporate vaginal microbiota assessment into cervical cancer screening and prevention strategies, especially in resource-limited settings.