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Association of asymptomatic bacterial vaginosis with persistence of female genital human papillomavirus infection

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Abstract

More data are needed on the role of abnormal vaginal microbiota in the natural history of cervical human papillomavirus (HPV) infections. Our purpose was to study the prevalence of mixed flora (MF), bacterial vaginosis (BV) and yeast infection in women with known HPV outcomes during the 72-month follow-up (FU). Asymptomatic pregnant women (N = 329) were enrolled in the third trimester of their pregnancy. Pap smears and HPV genotyping samples were taken at baseline and at 12-, 24-, 36- and 72-month FU visits, with one additional sample at 2 months for HPV. HPV testing was done with nested PCR and Multimetrix assay to determine the point prevalence and persistence of HPV. Conventional Pap smears were scored for MF, BV and yeast infection. Covariates of the outcomes were analyzed using generalized estimating equation (GEE) and Poisson regression. Of the women, 76.6% (252/329) tested HPV-positive at least once during the FU. BV was detected in 12.2% (40/329), MF in 57.4% (189/329) and yeast infection in 22.9% (73/329) of the women. HPV-positive women had significantly more leucocytes in their Pap smear (p = 0.023) than the HPV-negative ones. MF (OR 2.75, 95% CI 1.77–4.27) and yeast infection (p = 0.007) were linked with HPV positivity. BV but not yeast infection was a significant covariate of HPV persistence (p = 0.024; OR 2.15, 95% CI 1.13–4.08). MF and yeast infection were associated with prevalent cervical HPV infection. In the longitudinal setting, BV predicted HPV persistence, implicating that treatment of asymptomatic BV in women with cervical HR-HPV infections might be justified.

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Acknowledgements

The authors would like to thank Drs. Marjut Rintala, and Virpi Rantanen and midwife Elisa Hovimäki for participating in the enrolment of the women in the FFHPV study and their clinical follow-up. The skilful technical assistance of Mrs. Tatjana Pescova, Mariia Valkama, and Keitlin Adel is gratefully acknowledged.

Finnish Family HPV Study has been financially supported by The Finnish Academy, the Cancer Foundations of South-Western Finland, The Cancer Foundation of Finland, The Finnish Medical Foundation, The Government special Foundation (EVO) to Turku University Hospital.

This work has been presented as an oral communication in EUROGIN Congress in Salzburg, Austria, June 15-18, 2016.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Turku, Box 52, FIN-20520, Turku, Finland

    K. Kero & S. Grenman

  2. Department of Obstetrics and Gynaecology, Department of Oral Pathology, Turku University Hospital, P.O. Box 52, FIN-20521, Turku, Finland

    K. Kero

  3. Medicity Research Laboratory and Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Lemminkäisenkatu 2, FIN-20520, Turku, Finland

    J. Rautava & S. Syrjänen

  4. Department of Pathology, Turku University Hospital, Turku, Finland

    J. Rautava & S. Syrjänen

  5. Department of Clinical Research, Biohit Oyj, Helsinki, Finland

    K. Syrjänen

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  1. K. Kero
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Correspondence to K. Kero.

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Kero, K., Rautava, J., Syrjänen, K. et al. Association of asymptomatic bacterial vaginosis with persistence of female genital human papillomavirus infection. Eur J Clin Microbiol Infect Dis 36, 2215–2219 (2017). https://doi.org/10.1007/s10096-017-3048-y

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  • DOI: https://doi.org/10.1007/s10096-017-3048-y

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