Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Front Cell Infect Microbiol. 2023 Mar 16;13:1145215. doi: 10.3389/fcimb.2023.1145215. eCollection 2023.
Human papillomavirus (HPV) infection, especially persistent high-risk HPV, is associated with cervical cancer. Female reproductive tract microecological disorders and lower genital tract infections have been increasingly correlated with HPV infection and cervical lesions. Due to their common risk factors and transmission routes, coinfection with other sexually transmitted infections (STIs) has become a concern. Additionally, the clinical significance of subtypes appear to vary. This study aimed to assess the correlations between common STIs and HPV infection, and to investigate the clinical significance of subtypes.
We recruited 1,175 patients undergoing cervical cancer screening at the Peking University First Hospital gynecological clinic from March 2021 to February 2022 for vaginitis and cervicitis tests. They all received HPV genotyping and detection of STIs, and 749 of them underwent colposcopy and cervical biopsy.
Aerobic vaginitis/desquamative inflammatory vaginitis and STIs (mainly single STIs) were found significantly more often in the HPV-positive group than in the HPV-negative group. Among patients with a single STI, rates of infection with herpes simplex virus type 2 or UP6 in the HPV-positive group were significantly higher than in the HPV-negative group (OR: 1.810, 95%CI: 1.211-2.705, P=0.004; OR: 11.032, 95%CI: 1.465-83.056, P=0.020, respectively).
Through detailed typing, a correlation was found between different subtypes and HPV infection. These findings suggest that greater attention should be paid to detecting vaginal microecological disorders in those who are HPV-positive. Further, lower genital tract infections, including both vaginal infections and cervical STIs, are significantly more common among women who are HPV-positive and who thus require more thorough testing. Detailed typing and targeted treatment of should become more routine in clinical practice.
人乳头瘤病毒（HPV）感染，尤其是持续性高危 HPV 感染，与宫颈癌有关。女性生殖道微生态失调和下生殖道感染与 HPV 感染和宫颈病变的关系日益密切。由于它们具有共同的危险因素和传播途径，与其他性传播感染（STI）的合并感染已成为一个关注点。此外，不同亚型的临床意义似乎也有所不同。本研究旨在评估常见 STI 与 HPV 感染之间的相关性，并探讨亚型的临床意义。
我们招募了 1175 名在北京大学第一医院妇科诊所接受宫颈癌筛查的患者，进行阴道炎和宫颈炎检查。所有患者均接受 HPV 基因分型和 STI 检测，其中 749 名患者接受阴道镜检查和宫颈活检。
在 HPV 阳性组中，细菌性阴道炎/脱屑性炎性阴道炎和 STI（主要为单一性 STI）的检出率明显高于 HPV 阴性组。在单一性 STI 患者中，HPV 阳性组单纯疱疹病毒 2 型或 UP6 感染率明显高于 HPV 阴性组（OR：1.810，95%CI：1.211-2.705，P=0.004；OR：11.032，95%CI：1.465-83.056，P=0.020）。
通过详细分型，发现不同 亚型与 HPV 感染之间存在相关性。这些发现提示，对于 HPV 阳性者，应更加重视阴道微生态失调的检测。此外，下生殖道感染，包括阴道感染和宫颈 STI，在 HPV 阳性者中更为常见，因此需要更彻底的检测。在临床实践中，应更常规地进行 详细分型和靶向治疗。
