Background The role of the cervico-vaginal microbiome in the incidence and persistence of HPV infection is not well understood, particularly in the context of HIV infection. It is critical to understand this relationship in women living with HIV (WLWH) due to much higher rates of HPV-related disease in this population.

Methods WLWH were offered three doses of qHPV vaccine in a multi-centre study. Visits were at months -3, 0, 2, 6, 12, 18, 24, and annually thereafter. Participants provided health data, HPV DNA samples, and cervico-vaginal swabs for microbiota sequencing (cpn60 amplicon). Persistent HPV was defined as the same HPV type in samples detected at ≥2 consecutive visits.

Results 283 cervico-vaginal microbiota samples from 186 women were sequenced (1–3 samples/woman). Samples were taken between 3–8 years post-vaccination. Participants were predominantly Black (39.2%) and Caucasian (37.1%). At baseline, the median age was 38 years (range: 13–66, IQR: 32–45), median CD4 count was 490 cells/mm³ (IQR: 370–680), and 67.4% had an HIV viral load <50 copies/mL. At the time of microbiota swab collection, median CD4 count was 619 (IQR: 409–794). Samples taken at the time of incident HPV detection (n=44) displayed significantly higher relative abundance of Gardnerella vaginalis A than samples without incident HPV. Samples from women with persistent oncogenic HPV infection (n=41) had greater relative abundances of Porphyromonas uenonis and Prevotella timonensis than samples without persistent HPV.

Conclusion This data supports previous reports of an association between Gardnerella vaginalis subtype A and HPV incidence. Porphyromonas uenonis and Prevotella timonensis should be further explored as potential co-factors in HPV persistence.

Disclosure No significant relationships.