Schistosome Infection is Associated With High-Risk Human Papillomavirus Persistence, Together With Altered Cervicovaginal Microbiota

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Schistosoma haematobium infection may impair female genital mucosal antiviral defense. We sought to determine whether women with S. haematobium infection had higher odds of high-risk human papillomavirus (HR-HPV) persistence, a prerequisite to cervical cancer. We also examined cervicovaginal dysbiosis, which has been linked to HR-HPV persistence and schistosome infection. In 96 Tanzanian women with baseline and 9- to 12-month follow-up samples, we performed HPV genotyping, schistosome antigen quantification, and 16S rRNA sequencing. Both S. haematobium (odds ratio: 4.7 [1.3-16.5], P = .017) and Gardnerella-dominant microbiome (P = .049) were associated with HR-HPV persistence, suggesting these factors may contribute to high cervical cancer rates in Africa.