Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing, China

Abstract

BackgroundThe incidence of lower genital tract infections in China has been increasing in recent years. The link between high-risk human papillomavirus (HR-HPV) and other sexually transmitted diseases (STDs) remains unclear.MethodsFrom March to October 2014, gynecological examinations and questionnaires were conducted on 1218 married women. Cervical secretions and vaginal swab specimens were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Ureaplasma urealyticum (UU), yeast, clue cells and HR-HPV.ResultsLaboratory results were available for 1195 of 1218 married women. HR-HPV was detected in 7.0% of participants. Forty-seven percent of women had lower genital tract infections (LGTIs). UU was the most common infection (35.5%), followed by bacterial vaginosis (BV) (10.5%), yeast infection (3.7%), CT (2.2%), and Trichomonas vaginalis (1.7%). BV was associated with an increased risk of HR- HPV (P < 0.0001; odds ratio, 3.0 [95% CI, 1.7–5.4]). There was a strong correlation between abnormal cervical cytology and HR-HPV infection (P < 0.0001).ConclusionsThe prevalence of LGTIs in Beijing is at a high level. It is clinically important to screen for the simultaneous presence of pathogens that cause co-infections with HR-HPV.

Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy

“…However, several recent studies investigating the role of cervical co-infections of Ureaplasma spp. and other STIs in association with hrHPV, have supposed that these could be possible cofactors interacting with HPV in the development of precancerous and cancerous cervical lesions [31][32][33][34][35][36].…”

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

“…BV was described in 20% of the ASC-US group and 25% of the ASC-H group. Other studies have also reported a predominance of BV but with different frequencies [19,20] . The characteristic "clue cells" may hide the atypical character of real lesions, and the satisfied criteria would be indicative of ASC.…”

“…When correlating the vaginal microbiota with HR-HPV in ASC-US cytology, we observed a predominance of BV, but there was no statistically significant difference with HR-HPV positivity. Other studies have pointed out an association between BV and HR-HPV infection, suggesting BV may be a cofactor for squamous intraepithelial lesions due the action of pathogens causing inflammatory processes and microabrasions on the cervical epithelium [19] . A significantly higher frequency for Candida spp.…”

“…Therefore, it is important to determine the correlation between abnormal vaginal microbiological activity and atypical squamous cells [19] . Inflammatory cytology may result from nonspecific cervical processes or genital infections by Chlamydia trachomatis , Candida albicans , TV, BV, and herpes simplex virus [20] .…”

The Investigation of Chlamydia trachomatis and Ureaplasma urealyticum Coinfections in HPV Positive and HPV Negative Women

“…urealyticum üretrit, vajinit, servisit, spontan düşük ve infertilitenin sık görülen sebebi olup, vajinal kolonizasyon kadınlarda %40-80 arasında görülür. U. urealyticum infeksiyonunun HR HPV ve servikal kanserin patogenezi ile ilişkili olduğu, hem hücresel anomalileri başlatmada hem de viral kalıcılığında rol oynayabileceği birçok çalışmada bildirilmiştir [20,26] . U. urealyticum infeksiyonu HPV pozitif kadınlarda %30.5 (61/200) oranında, HPV negatif kadınlarda %23 (23/100) oranında tespit edilmiştir.…”