Abstract
Objective We here evaluated the association between human papillomavirus (HPV) infection and vaginal infections, including bacterial vaginosis (BV), trichomonas vaginalis (TV), and vulvovaginal candidiasis (VVC). Methods A total of 4,449 women were enrolled in this study and given gynecological examinations. HPV genotyping and viral load determination were performed using a real-time PCR. Vaginal infections were diagnosed using wet mounts of vaginal secretions, gram-stained vaginal secretion smears, and chemical enzyme kits. Results In this study, the overall HPV-positive rate was 25.06%, and vaginal infection tended to occur in women with HPV infection (P < 0.05). HPV infection tended to occur in BV- and TV-positive women (P < 0.05) and not in women with microecological disorders, intermediate type BV, VVC, or coinfection (P > 0.05). The most common genotypes were HPV58 and HPV53 in women with normal vaginal microecology and HPV16 and HPV52 in the women suffering from vaginal infection. The viral loads among groups for HPV16 and HPV52 showed no statistically significant differences (P=0.940; P=0.167). Conclusions Our study revealed that BV and TV are associated with HPV infection, especially high-risk HPV infection, while VVC has no association with HPV infection. Further studies are needed to explore the detailed mechanism.
Highlights
Cervical cancer is one of the leading causes of death from gynecologic malignancy, and it has an estimated 530,000 new cases annually worldwide with 270,000 deaths [1]
Among the 1,115 women with human papillomavirus (HPV) infection, 24.48% (273/1,115) suffered from vaginal infection (BV, vulvovaginal candidiasis (VVC), trichomonas vaginalis (TV), and coinfection), while 20.97% of the 3,334 (699/3,334) women without HPV infection suffered from vaginal infection. ere was a significant difference in the prevalence of vaginal infection between the women with and without HPV infection (χ2 6.058, P < 0.05), and the prevalence in HPV infected women was higher
We compared the rate of HPV infection in each group with that of the normal vaginal microecology group. ere was a significant difference between women with bacterial vaginosis (BV) infection, TV infection, and normal vaginal microecology (P < 0.05), while there was no significant difference between women with microecological disorders, intermediate type BV, VVC, coinfection, and those with normal vaginal microecology (P > 0.05)
Summary
Cervical cancer is one of the leading causes of death from gynecologic malignancy, and it has an estimated 530,000 new cases annually worldwide with 270,000 deaths [1]. In China, about 106,430 new cases of cervical cancer are diagnosed annually, with 47,739 deaths (estimates for 2018). Cervical cancer is the sixth major cause of female cancer and the eighth major cause of female cancer deaths in China [2]. HPV infections are transient and spontaneously cleared by the host with no intervention or clinical consequences. 5%–10% of HPV infections cannot be cleared, and they become persistent infections that can cause cervical and other types of cancer. It is difficult to predict whether HPV infection would disappear spontaneously or lead to malignant transformation
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