Role of cervicovaginal microbiome in ALA-PDT-mediated HPV clearance in patients with cervical HSIL

5-Aminolevulinic acid photodynamic therapy (ALA-PDT) demonstrates a high rate of lesion remission and offers significant therapeutic advantages in managing cervical high-grade squamous intraepithelial lesions (HSIL). However, approximately 40% of patients remain positive for human papillomavirus (HPV) following treatment, which intensifies the psychological burden and increases the risk of lesion recurrence. The cervicovaginal microbiome play a pivotal role in the persistence of HPV infection. So, the contribution of the cervicovaginal microbiome to ALA-PDT-mediated HPV clearance in patients with cervical HSIL was investigated. A total of 74 patients diagnosed with cervical HSIL who underwent ALA-PDT were enrolled. Cervicovaginal secretions were collected from all participants before the treatment. Post-treatment cervicovaginal secretions were obtained from 42 of these patients 3 months following treatment. 16S ribosomal RNA sequencing were conducted on all cervicovaginal secretion samples. The cervicovaginal microbiome profiles before and after ALA-PDT were characterized in patients with different HPV clearance outcomes.