Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities

Abstract

The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas© HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 ± 10.65 years (range 21-75). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs. 13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal milieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.

Does Aerobic Vaginitis Have Adverse Pregnancy Outcomes? Prospective Observational Study

“…Many earlier studies have not recognized or ignored the contributing effect of AV on perinatal outcomes [25,26]. However, new culture-based studies confirmed the association between AV and preterm birth [4,27].…”

Persistence rate of cervical human papillomavirus infections and abnormal cytology in Rwanda

“…While HPV persistence is a strong predictor of HSIL and the development of cervical cancer, LSIL may instead be associated with other clinical conditions. LSIL has been associated with current chlamydia infection , trichomoniasis and bacterial vaginosis . As the number of cases of individual STIs and RTIs was low, we did not attempt to stratify individual RTIs and STIs in the binary logistic regression analysis.…”

Inflammatory cells in liquid‐based cytology smears classified as bacterial vaginosis

“…Finally, cellular atypia was significantly associated with BV‐L (9.6% against 5.7%), although some reports did not find an association between cervical cytological abnormalities and BV others observed that both HPV infection and epithelial atypia were associated with BV . There has been no study about the association of atypia along with the presence of leukocytes (in cases with BV diagnosis, as shown here).…”