Is bacterial vaginosis associated with cervical intraepithelial neoplasia?

Abstract

Previous research has produced conflicting results regarding the association of bacterial vaginosis (BV) and cervical intraepithelial neoplasia (CIN). These studies have been weakened in their conclusions mainly by failure to adequately control for the presence of sexually transmitted infections (STIs). One proposed mechanism suggesting that carcinogenic nitrosamines acting either independently or via human papilloma virus (HPV) has not been fully tested previously. We undertook a prospective, case-controlled, cross-sectional study where the presence of STIs, in particular human papillomavirus (HPV) which is known to be associated with the development of CIN, was controlled for. Women with BV were not found to have CIN more frequently than women with normal vaginal flora and the quantities of nitrosamines produced by women with BV did not differ significantly from women without BV. We thus found that BV is not associated with CIN.

Relationship among bacterial vaginosis, local inflammatory response and presence of cervical intraepithelial neoplasia in women with and without human papilloma virus infection

“…According to Boyle et al [11] women with BV were not found to have CIN more frequently than women with normal vaginal flora.…”

Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000–2012

“…Alternatively, there might also be effect modification of association of HPV with CIN due to the presence of other RTIs. There is some evidence to suggest that bacterial vaginosis is not associated directly with CIN [18] and abnormal production of nitrosamines has been implicated [19]. However, biological associations such as synergism of other RTIs with occurrence of CIN cannot be ruled out emphatically [19].…”

Present-day trends in treatment of bacterial vaginosis

“…Кроме того, доказано, что БВ повышает риск зараже-ния ВИЧ [10], Neisseria gonorrhoeae, Clamydia trachomatis, Human herpes virus. Следует отдельно отметить, что нару-шения микрофлоры влагалища считаются кофактором развития цервикальной неоплазии (CIN), что связано с определенной ролью состояния влагалищного микро-биоценоза в восприимчивости к вирусу папилломы чело-века [11][12][13][14].…”