{
  "abstract": "Background: Persistent high-risk human papillomavirus (hrHPV) infection causes virtually all high-grade squamous intraepithelial lesions (HSIL) and cervical cancer, but only a minority progress, implicating host and microenvironmental cofactors. The cervicovaginal microbiome (CVM), particularly Lactobacillus-dominated communities, may influence hrHPV persistence, clearance, and response to HSIL treatment.\n\nObjective: To map evidence linking the CVM with hrHPV clearance and outcomes after HSIL treatment, including loop electrosurgical excision procedure (LEEP) and conization, using PRISMA-ScR and Arksey and O’Malley frameworks.\n\nMethods: Literature on cervicovaginal microbiota, community state types (CSTs), HPV natural history, HSIL/CIN treatment, probiotics, microbiome-directed interventions, and predictive biomarkers was systematically searched and narratively synthesized using a Population-Concept-Context framework.\n\nResults: Sixty-six sources were charted. Lactobacillus crispatus -dominated communities (CST-I) were associated with hrHPV clearance and favorable post-treatment outcomes, whereas CST-IV, bacterial vaginosis, and increased alpha-diversity were associated with hrHPV persistence, greater HSIL severity, and treatment failure. Proposed mechanisms include lactic acid-mediated pH regulation, D-lactic acid signaling, and modulation of viral oncoproteins and immune responses. Excision altered the CVM, with restoration of Lactobacillus dominance accompanying viral clearance. Microbial-signature machine-learning models showed promising but preliminary predictive performance. Oral and intravaginal probiotics showed inconsistent but generally favorable trends, with strongest evidence for intravaginal L. crispatus transplantation. Gut microbiome diversity may also influence chemoradiotherapy outcomes in invasive cervical cancer.\n\nConclusion: The CVM is a promising predictor of hrHPV clearance and HSIL treatment response. However, methodological heterogeneity, small cohorts, and limited prospective evidence restrict clinical translation. Large prospective studies and rigorously designed trials are needed to validate predictive signatures and determine whether microbiome profiling or targeted modulation can improve HSIL management and outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Uganda Cancer Institute",
    "Department of Obsetrics and Gynecology Oncology Unit, University of Witwatersrand",
    "Discipline of Anatomical Pathology, School of Medicine, College of Health Sciences, Universitry of KwaZulu-Natal",
    "National Health Laboratory Services",
    "Department of Global Health, Rollins School of Public Health, Emory University",
    "School of Public Health, Makerere University",
    "Wits Planetary Health Research, Faculty of Health Sciences and affiliate of IDORI, University of Witwatersrand"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Benjamin Mwesige"
    },
    {
      "affs": [
        0
      ],
      "name": "Bridget Angucia"
    },
    {
      "affs": [
        1
      ],
      "name": "Langanani Mbodi"
    },
    {
      "affs": [
        2
      ],
      "name": "Absalom Mwazha"
    },
    {
      "affs": [
        0
      ],
      "name": "Nixon Niyonzima"
    },
    {
      "affs": [
        3
      ],
      "name": "Judith Mwansa-Kambafwile"
    },
    {
      "affs": [
        4
      ],
      "name": "Robert F. Breiman"
    },
    {
      "affs": [
        5
      ],
      "name": "Henry Zakumumpa"
    },
    {
      "affs": [
        6
      ],
      "name": "Admire Chikandiwa"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0jrrm6n33f5ff.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1972845",
  "fulltext_url": null,
  "id": "0jrrm6n33f5ff",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1972845/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2404|Reproductive tract infections research"
    ]
  ],
  "openalex": "W7223183507",
  "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1972845/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-22",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/0jrrm6n33f5ff.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1972845",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1972845/full"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2404|Reproductive tract infections research",
      "subfield": "microbiology"
    }
  ],
  "title": "The cervicovaginal microbiome as a candidate correlate and potential predictor of HPV clearance and treatment response after HSIL therapy: a scoping review",
  "title_text": "The cervicovaginal microbiome as a candidate correlate and potential predictor of HPV clearance and treatment response after HSIL therapy: a scoping review",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:13Z",
  "url": "https://research.draconitic.com/paper/0jrrm6n33f5ff",
  "venue": "Frontiers in Oncology",
  "versions": []
}