Association of abnormal vaginal microflora and HPV infection in cervical precancerous lesions: a retrospective study

Abstract

Introduction: The aim of this study was to analyze the correlation between abnormal vaginal microflora and different types of human papillomavirus (HPV) infection and cervical precancerous lesions during the perimenopausal period.

Methodology: This retrospective study included women patients who underwent liquid-based cytologic test (LBC), HPV test, leucorrhea routine test, or routine urine test at the China-Japan Friendship Hospital between October 2019 and January 2020. A cut-off of 45 years was used as the cut-off age for menopause. The positivity and subtypes of HPV were determined using a chip-based assay. Vaginal microflora was determined using an HB-2012a flow-through hybridization instrument.

Results: A total of 132 patients were included in this study. 97 patients were younger than 45 years of age, with a median age of 35 (8.0), and 35 patients ≥ 45 years of age, with a median age of 55 (11.0). There were no significant differences in cytology, type of cervical lesion, HPV type, and common pathogens of the reproductive tract (all p > 0.05). The multivariable analysis showed that only HPV-16 infection lesions (OR: 2.825, 95% CI: 1.121-7.120, p = 0.028), Chlamydia trachomatis infection (OR: 0.142, 95% CI: 0.024-0.855, p =0.033), and Mycoplasma infection (OR: 7.750, 95% CI: 1.603-37.474, p = 0.011) were independent risk factors for cervical precancerous lesions. The menopausal status (with age < 45 or > 45 years as its surrogate) was not associated with cervical precancerous lesions.

Conclusions: Menopause was not associated with cervical precancerous lesions. The results suggest that the prevention and treatment of HPV-16, Chlamydia trachomatis infection, and Mycoplasma infection could be significant to prevent the occurrence of cervical precancerous lesions.