CANDIDA-GARDNERELLA CO-COLONIZATION AS A POTENTIAL MARKER OF CST IV DYSBIOSIS AND HIGH-GRADE CERVICAL NEOPLASIA IN HR-HPV-POSITIVE WOMEN

E. Kydyrbayeva, Y. Iztleuov, Gulmira Iztleuova

2026

Full text Open access: Hybrid Metadata (CSL-JSON)
DOI 10.52532/3135-3940-2026-2-695
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Relevance: Vaginal microbiome dysbiosis with loss of lactobacillus dominance (Community State Type (CST) IV) is increasingly regarded as an independent cofactor of high-risk human papillomavirus (HR-HPV) persistence and progression of cervical intraepithelial neoplasia. However, the role of interkingdom interactions between Candida spp. and Gardnerella vaginalis in the development of biofilm-associated dysbiosis remains insufficiently characterized.The study aimed to evaluate the association between combined Candida spp. and G. vaginalis colonization and the vaginal microbiome CST profile, HR-HPV status, and CIN2+ risk, and to explore potential interactions among these microorganisms using a prespecified multiplicative interaction model.Materials and Methods: A prospective single-center cohort study was conducted among women aged 21-70 years who were examined in the fourth quarter of 2025 (n=100). The microbiome was assessed by quantitative PCR (Femoflor-16); HR-HPV was detected by PCR with genotyping. Cytology was interpreted according to the Bethesda System, and the histological outcome was defined as CIN2/3 or invasive cancer. Pearson’s chi-square test or Fisher’s exact test, Spearman correlation analysis, and multivariable logistic regression including a Candida × G. vaginalis interaction term were used.Results: HR-HPV was detected in 72% of participants, CST IV in 69%, and CIN2+ in 27%. Candida spp. + G. vaginalis co-colonization was observed in 30% of participants and was more frequent in CST IV than in lactobacillus-dominated CSTs (38.5% vs. 14.3%; p = 0.04). In regression analysis, co-colonization was associated with the highest odds of CIN2+ (OR = 4.84; 95% CI: 2.41-9.70; p < 0.001). The interaction term was statistically significant (OR = 1.62; 95% CI: 1.15-2.27; p = 0.019), and the relative excess risk due to interaction (RERI) was 1.24.Conclusion: The Candida-Gardnerella dyad may serve as a combined marker of biofilm-associated dysbiosis and HPV-related oncogenic risk. These findings support further evaluation of extended microbiome diagnostics for risk stratification in HR-HPV-positive women, but require validation in larger prospective cohorts.