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Cervicovaginal dysbiosis is thought to exacerbate this process by potentially facilitating HPV acquisition and persistence, and promoting viral transformation (including E6/E7 expression, viral integration, and genomic instability), and supporting secondary infections, such as those caused by Chlamydia trachomatis (Figure 3)

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26 As the disease progresses, cells are no longer able to secrete enough insulin to compensate for the abnormally high blood glucose, leading to progression to prediabetes or T2D