Bacterial Vaginosis and the Natural History of Human Papillomavirus

Caroline C King,Susan Cu-Uvin,Jack D Sobel,Keerti V Shah,Robert S Klein,Anne M Rompalo,Jeffrey Wiener,Denise J Jamieson

doi:10.1155/2011/319460

Abstract

Objective. To evaluate associations between common vaginal infections and human papillomavirus (HPV). Study Design. Data from up to 15 visits on 756 HIV-infected women and 380 high-risk HIV-uninfected women enrolled in the HIV Epidemiology Research Study (HERS) were evaluated for associations of bacterial vaginosis, trichomoniasis, and vaginal Candida colonization with prevalent HPV, incident HPV, and clearance of HPV in multivariate analysis. Results. Bacterial vaginosis (BV) was associated with increased odds for prevalent (aOR = 1.14, 95% CI: 1.04, 1.26) and incident (aOR = 1.24, 95% CI: 1.04, 1.47) HPV and with delayed clearance of infection (aHR = 0.84, 95% CI: 0.72, 0.97). Whereas BV at the preceding or current visit was associated with incident HPV, in an alternate model for the outcome of incident BV, HPV at the current, but not preceding, visit was associated with incident BV. Conclusion. These findings underscore the importance of prevention and successful treatment of bacterial vaginosis.

Highlights

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) among young adult women, and it plays a critical role in the development of cervical cancer [1, 2]
In a model adjusted for a combined indicator of HIV status and CD4 group, bacterial vaginosis was significantly associated with increased odds for prevalent HPV among all HIV Epidemiology Research Study (HERS) women
In a model adjusted for a combined indicator of HIV status and CD4 group, bacterial vaginosis at the preceding visit was significantly associated with 24% increased odds for incident HPV among all HERS women (Table 3)

Summary

Objective

To evaluate associations between common vaginal infections and human papillomavirus (HPV). Data from up to 15 visits on 756 HIV-infected women and 380 high-risk HIV-uninfected women enrolled in the HIV Epidemiology Research Study (HERS) were evaluated for associations of bacterial vaginosis, trichomoniasis, and vaginal Candida colonization with prevalent HPV, incident HPV, and clearance of HPV in multivariate analysis. Bacterial vaginosis (BV) was associated with increased odds for prevalent (aOR = 1.14, 95% CI: 1.04, 1.26) and incident (aOR = 1.24, 95% CI: 1.04, 1.47) HPV and with delayed clearance of infection (aHR = 0.84, 95% CI: 0.72, 0.97). These findings underscore the importance of prevention and successful treatment of bacterial vaginosis

Introduction

Materials and Methods

Results

Comment