Association between human papillomavirus infection and common sexually transmitted infections, and the clinical significance of different Mycoplasma subtypes

Abstract

IntroductionHuman papillomavirus (HPV) infection, especially persistent high-risk HPV, is associated with cervical cancer. Female reproductive tract microecological disorders and lower genital tract infections have been increasingly correlated with HPV infection and cervical lesions. Due to their common risk factors and transmission routes, coinfection with other sexually transmitted infections (STIs) has become a concern. Additionally, the clinical significance of Mycoplasma subtypes appear to vary. This study aimed to assess the correlations between common STIs and HPV infection, and to investigate the clinical significance of Mycoplasma subtypes.MethodsWe recruited 1,175 patients undergoing cervical cancer screening at the Peking University First Hospital gynecological clinic from March 2021 to February 2022 for vaginitis and cervicitis tests. They all received HPV genotyping and detection of STIs, and 749 of them underwent colposcopy and cervical biopsy.ResultsAerobic vaginitis/desquamative inflammatory vaginitis and STIs (mainly single STIs) were found significantly more often in the HPV-positive group than in the HPV-negative group. Among patients with a single STI, rates of infection with herpes simplex virus type 2 or UP6 in the HPV-positive group were significantly higher than in the HPV-negative group (ORadj: 1.810, 95%CI: 1.211–2.705, P=0.004; ORadj: 11.032, 95%CI: 1.465–83.056, P=0.020, respectively).DiscussionThrough detailed Mycoplasma typing, a correlation was found between different Mycoplasma subtypes and HPV infection. These findings suggest that greater attention should be paid to detecting vaginal microecological disorders in those who are HPV-positive. Further, lower genital tract infections, including both vaginal infections and cervical STIs, are significantly more common among women who are HPV-positive and who thus require more thorough testing. Detailed typing and targeted treatment of Mycoplasma should become more routine in clinical practice.

Association between co-infection with Chlamydia trachomatis or Mycoplasma genitalium and cervical lesions in HPV-positive population in Hunan, China: a cross-sectional study

“…As for M. genitalium infection, there is limited research on its association with HPV infection and cervical lesions. A study by A et al found no association between M. genitalium infection and HPV infection or cervical lesions [ 9 ], which is consistent with our findings. Currently, most studies are cross-sectional or retrospective.…”

“…Several studies have indicated an association between C. trachomatis infection and HPV infection as well as cervical lesions [ 8 , 23 ]. However, other studies have suggested that C. trachomatis infection does not increase the risk of HPV infection and cervical lesions [ 9 , 10 , 25 ], which aligns with our research findings. The conflicting results may stem from differences in cohorts or limitations in sample size.…”

“…For instance, among the general female population visiting gynecology departments in Sichuan province, China, the infection rates of C. trachomatis and M. genitalium were reported as 6.5% and 2.6%, respectively [ 10 ]. In a study on women undergoing cervical cancer screening in Beijing, China, the infection rates of C. trachomatis and M. genitalium were 11.3% and 1.0%, respectively [ 9 ]. In our study, the infection rate of C. trachomatis (3.87%) was slightly lower than that reported in other studies, while the infection rate of M. genitalium (3.64%) was slightly higher.…”

“…However, conflicting conclusions have also been reported. A cross-sectional study conducted in Beijing, China, found no significant difference in C. trachomatis infection rates between HPV-infected and non-HPV-infected groups or between groups with different cervical biopsy results [ 9 ]. Similarly, a retrospective analysis conducted in Sichuan, China, found no association between C. trachomatis infection and high-risk HPV infection [ 10 ].…”

Human papillomavirus associated cervical lesion: pathogenesis and therapeutic interventions

“… 271 Phenylactic acid, a phenolic acid phytochemical predominantly produced by L actobacillus , represses E6/E7 expression while promoting cervical cancer cell migration and via IKK/NF‐κB‐mediated MMP‐9 activation. 272 Additionally, coinfections in the vaginal microenvironment, such as Chlamydia trachomatis, 273 , 274 herpes simplex virus2, Ureaplasma urealyticum, 275 can increase the risk of HPV‐associated cervical lesion and cancer; some of these coinfections influence the expression HPV oncogene. 276 Researchers have found that the presence of specific anaerobic taxa, including Megasphaera , P revotella timonensis , and Gardnerella vaginalis , is associated with CIN2 persistence and slower regression, 277 suggesting that VMB composition may serve as a useful biomarker for predicting disease outcome and tailoring surveillance in the future.…”