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This study aimed to explore the changes of the vaginal microbiota and enzymes in the women with high-risk human papillomavirus (HR-HPV) infection and cervical lesions. A total of 448 participants were carried out HPV genotyping, cytology tests, and microecology tests, and 28 participants were treated as sub-samples, in which vaginal samples were characterized by sequencing the bacterial 16S V4 ribosomal RNA (rRNA) gene region. The study found the prevalence of HR-HPV was higher in patients with BV ( P  = 0.036). The HR-HPV infection rate was 72.73% in  G. vaginalis  women, which was significantly higher than that of women with  lactobacillus  as the dominant microbiota (44.72%) ( P  = 0.04). The positive rate of sialidase (SNA) was higher in women with HR-HPV infection (P = 0.004) and women diagnosed with cervical intraepithelial neoplasia (CIN) ( P  = 0.041). In HPV (+) women, the α-diversity was significantly higher than that in HPV (−) women. The 16S rRNA gene-based amplicon sequencing results showed that  Lactobacillus  was the dominant bacteria in the normal vaginal microbiota. However, the proportion of  Gardnerella  and  Prevotella  were markedly increased in HPV (+) patients.  Gardnerella  and  Prevotella  are the most high-risk combination for the development of HPV (+) women. The SNA secreted by  Gardnerella  and  Prevotella  may play a significant role in HPV infection progress to cervical lesions.

Changes of the vaginal microbiota in HPV infection and cervical intraepithelial neoplasia: a cross-sectional analysis