{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:43:52Z","timestamp":1792172632036,"version":"4.4.0"},"reference-count":57,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,1]]},"abstract":"\n Background<\/jats:title>\n \n Persistent infection with high\u2010risk human papillomavirus can lead to cervical dysplasia and cancer. Recent studies have suggested associations between the composition of the vaginal microbiota, infection with human papillomavirus (\n HPV<\/jats:styled-content>\n ) and progression to cervical dysplasia and cancer.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To assess how specific cervico\u2010vaginal microbiota compositions are associated with\n HPV<\/jats:styled-content>\n infection, cervical dysplasia and cancer, we conducted a systematic review and network meta\u2010analysis (registered in\n PROSPERO<\/jats:styled-content>\n :\n CRD<\/jats:styled-content>\n 42018112862).\n <\/jats:p>\n <\/jats:sec>\n \n Search strategy<\/jats:title>\n PubMed, Web of science, Embase and Cochrane database.<\/jats:p>\n <\/jats:sec>\n \n Selection criteria<\/jats:title>\n \n All original studies describing at least two community state types of bacteria (\n CST<\/jats:styled-content>\n ), based on molecular techniques enabling identification of bacteria, and reporting the association with\n HPV<\/jats:styled-content>\n infection, cervical dysplasia and\/or cervical cancer.\n <\/jats:p>\n <\/jats:sec>\n \n Data collection and analysis<\/jats:title>\n \n For the meta\u2010analysis, a network map was constructed to provide an overview of the network relationships and to assess how many studies provided direct evidence for the different vaginal microbiota compositions and\n HPV<\/jats:styled-content>\n , cervical dysplasia or cancer. Thereafter, the consistency of the model was assessed, and forest plots were constructed to pool and summarise the available evidence, presenting odds ratios and 95% confidence intervals.\n <\/jats:p>\n <\/jats:sec>\n \n Main results<\/jats:title>\n \n Vaginal microbiota dominated by non\u2010\n Lactobacilli<\/jats:italic>\n species or\n Lactobacillus iners<\/jats:italic>\n were associated with three to five times higher odds of any prevalent\n HPV<\/jats:styled-content>\n and two to three times higher for high\u2010risk\n HPV<\/jats:styled-content>\n and dysplasia\/cervical cancer compared with\n Lactobacillus crispatus<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n These findings suggest an association between certain bacterial community types of the vaginal microbiota and\n HPV<\/jats:styled-content>\n infection and\n HPV<\/jats:styled-content>\n \u2010related disease. This may be useful for guiding treatment options or serve as biomarkers for\n HPV<\/jats:styled-content>\n \u2010related disease.\n <\/jats:p>\n <\/jats:sec>\n \n Tweetable abstract<\/jats:title>\n \n This network meta\u2010analysis suggests an association between different vaginal bacterial community types and the risk of\n HPV<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.15854","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T16:31:19Z","timestamp":1561480279000},"page":"171-180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":339,"title":["The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"127","author":[{"given":"J","family":"Norenhag","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7649-9571","authenticated-orcid":false,"given":"J","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tumour and Cell Biology Centre for Translational Microbiome Research Karolinska Hospital Karolinska Institutet Stockholm Sweden"},{"name":"Science for Life Laboratory Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4472-840X","authenticated-orcid":false,"given":"M","family":"Olovsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4070-1587","authenticated-orcid":false,"given":"H","family":"Verstraelen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology Ghent University Hospital 0P4 Ghent University Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-2373","authenticated-orcid":false,"given":"L","family":"Engstrand","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tumour and Cell Biology Centre for Translational Microbiome Research Karolinska Hospital Karolinska Institutet Stockholm Sweden"},{"name":"Science for Life Laboratory Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-447X","authenticated-orcid":false,"given":"N","family":"Brusselaers","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tumour and Cell Biology Centre for Translational Microbiome Research Karolinska Hospital Karolinska Institutet Stockholm Sweden"},{"name":"Science for Life Laboratory Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1286-4579(00)00313-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.115867"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.12.011"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.811103.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi243"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)91112-9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.29.2.297-301.1991"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu330"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep16865"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1002611107"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105998"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045201"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.04.019"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(99)00291-9"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60022-7"},{"key":"e_1_2_7_17_1","volume-title":"Comprehensive Cervical Cancer Control: A Guide to Essential Practice","author":"World Health Organization","year":"2014"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_2_7_19_1","unstructured":"AHRQ.Methodology checklist for cross\u2010sectional study[www.ncbi.nlm.nih.gov\/books\/NBK35156\/]. 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