The human papillomavirus (HPV) gets around. Nearly half of Americans between the ages of 18 and 59 are infected with this sexually transmitted virus, according to a new report from the National Center for Health Statistics. The good news: More than 90% of HPV infections are cleared by the body within 2 years. The immune system may be just part of this action. The very bad news is that if they linger, the nasty types (HPV-16 and 18) are responsible for most of the 30,000 new cases of cancer (cervix, vagina, penis, anus and throat) each year. New vaccines can prevent the infection if young people are inoculated early enough. Prevalence is strikingly different based on race: Blacks: 33.7%

Whites: 21.6

Hispanics” 21.7

Asians: 11.9 Other risk factors Ethnicity: Caucasian and Asian women displaying a significantly greater prevalence of Lactobacillus spp. dominant microbiota, (genetics, douching) compared to Hispanic and Black women

Oral contraception

Smoking Probiotics may help clear the HPV A thorough review of that possibility appeared recently in Microbiome titled: The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next? Author Anita Mitra of Imperial College in London and her colleagues wrote: “There is emerging evidence which leads us to conclude that increased diversity of vaginal microbiota combined with reduced relative abundance of Lactobacillus spp. is involved in HPV acquisition and persistence and the development of cervical precancer and cancer.” Microbes may be involved via various mechanisms including: Lower pH (more acidic)

Lower diversity (as opposed to how diversity usually is aligned with health at other sites)

Certain lactobacilli may protect by producing large amounts of lactic acid.

L. gasseri may be associated with the most rapid clearance of acute HPV infection.

L. gasseri along with L. crispatus, is toxic to HPV-18-infected HeLa cervical cancer cells but not to normal cervical cell lines, independent of pH or lactate concentration.

Protective species may inhibit pathogen growth by producing bacteriocins. Role for synbiotics Several studies explored a role for synbiotics. One such study looked at 54 women with an HPV+low-grade squamous intraepithelial lesion. One group received a daily probiotic drink for 6 weeks while control group received none. Results: Clearance of cytological abnormalities: 60% of probiotic group vs, 31% control

60% of probiotic group vs, 31% control HPV clearance: 29% of probiotic group vs. 19% control Conclusions “Pre- and probiotics clearly present an enticing novel therapeutic approach to this disease, because they are cheap, easy to administer, with a low side effect profile, unlike the current gold standard treatment for high-grade CIN, which involves a surgical method that carries significant risk to future reproductive outcomes.”