Feng Fang, Hou Yue-Min, Zhang Yan, Wang Lu-Yuan, Li Pei-Pei, Guo Ying, An Rui-Fang
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Med (Lausanne). 2023 Jun 1;10:1138507. doi: 10.3389/fmed.2023.1138507. eCollection 2023.
Vaginal microecology has a definite influence on human papillomavirus (HPV) infection and clearance, but the specific correlation is still controversial. This research aimed to investigate the differences in the vaginal microenvironment of different types of HPV infection and also provide data supporting clinical diagnosis and treatment.
According to strict inclusion and exclusion criteria, the case data of 2,358 female patients who underwent vaginal microecology and HPV-DNA tests at the same time in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Xi'an Jiaotong University from May 2021 to March 2022 were retrospectively analyzed. The population was divided into two groups: an HPV-positive group and an HPV-negative group. HPV-positive patients were further classified into HPV16/18-positive group and HPV other subtypes positive group. The vaginal microecology of HPV-infected patients was analyzed using the chi-square test, Fisher's exact test, and logistic regression.
Among the 2,358 female patients, the HPV infection rate was 20.27% (478/2,358), of which the HPV16/18 infection rate was 25.73% (123/478), and the HPV other subtypes infection rate was 74.27% (355/478). The difference in HPV infection rates between the age groups was statistically significant ( < 0.01). The prevalence of mixed vaginitis was 14.37% (339/2,358), with bacterial vaginosis (BV) paired with aerobic vaginitis (AV) accounting for the majority (66.37%). The difference in HPV infection rates among mixed vaginitis was not statistically significant ( > 0.05). The prevalence of single vaginitis was 24.22% (571/2,358), with the most frequent being vulvovaginal (VVC; 47.29%, 270/571), and there was a significant difference in HPV infection rates among single vaginitis ( < 0.001). Patients with BV had a higher risk of being positive for HPV16/18 (OR: 1.815, 95% CI: 1.050-3.139) and other subtypes (OR: 1.830, 95% CI: 1.254-2.669). Patients with were at higher odds of other HPV subtype infections (OR: 1.857, 95% CI: 1.004-3.437). On the contrary, patients with VVC had lower odds of becoming infected with other HPV subtypes (OR: 0.562, 95% CI: 0.380-0.831).
There were disparities in HPV infection among different age groups; therefore, we should pay attention to the prevention and treatment of susceptible individuals. BV and are linked to HPV infection; hence, restoring the balance of vaginal microecology could assist in the prevention of HPV infection. As a protective factor for other HPV subtype infections, VVC may provide new insights into the development of immunotherapeutic therapies.
阴道微生态对人乳头瘤病毒（HPV）感染及清除有一定影响，但具体相关性仍存在争议。本研究旨在探究不同类型HPV感染的阴道微环境差异，并为临床诊断与治疗提供数据支持。
按照严格的纳入与排除标准，回顾性分析2021年5月至2022年3月在西安交通大学第一附属医院妇产科同时进行阴道微生态及HPV-DNA检测的2358例女性患者的病例资料。将研究对象分为两组：HPV阳性组和HPV阴性组。HPV阳性患者进一步分为HPV16/18阳性组和HPV其他亚型阳性组。采用卡方检验、Fisher确切概率法及logistic回归分析HPV感染患者的阴道微生态情况。
2358例女性患者中，HPV感染率为20.27%（478/2358），其中HPV16/18感染率为25.73%（123/478），HPV其他亚型感染率为74.27%（355/478）。各年龄组HPV感染率差异有统计学意义（<0.01）。混合性阴道炎患病率为14.37%（339/2358），其中细菌性阴道病（BV）合并需氧菌性阴道炎（AV）占多数（66.37%）。混合性阴道炎中HPV感染率差异无统计学意义（>0.05）。单纯性阴道炎患病率为24.22%（571/2358），最常见的是外阴阴道假丝酵母菌病（VVC；47.29%，270/571），单纯性阴道炎中HPV感染率差异有统计学意义（<0.001）。BV患者HPV16/18阳性（OR：1.815，95%CI：1.050 - 3.139）及其他亚型阳性（OR：1.830，95%CI：1.254 - 2.669）的风险更高。患有[此处原文缺失疾病名称]的患者感染其他HPV亚型的几率更高（OR：1.857，95%CI：1.004 - 3.437）。相反，VVC患者感染其他HPV亚型的几率较低（OR：0.562，95%CI：0.380 - 0.831）。
不同年龄组HPV感染存在差异，因此应关注易感个体的防治。BV和[此处原文缺失疾病名称]与HPV感染有关，恢复阴道微生态平衡有助于预防HPV感染。VVC作为其他HPV亚型感染的保护因素，可能为免疫治疗的发展提供新的思路。
