Avsaroglu Elif, Kaleli Babur, Kilic Derya, Kaleli Ilknur, Guler Tolga
Obstetrics and Gynecology, Denizli State Hospital, Denizli, TUR.
Obstetrics and Gynecology, Pamukkale University, Denizli, TUR.
Cureus. 2023 Dec 21;15(12):e50907. doi: 10.7759/cureus.50907. eCollection 2023 Dec.
Background Vaginal dysbiosis, an imbalance between species, can initiate some local changes in immune and metabolic signaling causing chronic inflammation. The mechanism of the clearance or progression of the HPV infection has not been uncovered yet. We hypothesized that vaginal dysbiosis may contribute to the persistence of the cervical HPV infection. Therefore we aimed to determine the association of lactobacillus dominancy index with cervical HR-HPV persistence. Methods A total of 100 women who were followed up because of high-risk HPV infection were defined as the target study group. The patients were evaluated in two groups; HPV positive (group with HPV persistence, n=43) and HPV negative (group with HPV clearance, n=57). Cervicovaginal swab samples and blood samples were evaluated for Nugent score, lactobacillus dominance, and white blood cell count. Statistical tests were performed by the IBM Statistical Product and Service Solutions (version 22, IBM SPSS Statistics for Windows, Armonk, NY) program. The continuous variables were presented using the mean±standard deviation (SD), and the categorical variables were presented as the number of cases and their percentage. A p value less than 0.05 (<0.05) was set as statistically significant. Results HPV persistence was observed in 43 (43%) patients. Univariate analysis revealed that age, menopausal status, and lactobacillus reduction were associated with HPV persistence (p<0.05). The median value of the Nugent score was similar among groups. After logistic regression analysis, lactobacillus reduction continued to be associated with HPV persistence, independent of age and menopause (OR: 2.668, 96% CI: 1.069-6.662, p<0.05) Conclusions A decrease in lactobacilli in the cervicovaginal microbiota is associated with the persistence of HPV, regardless of age and menopausal status in this study.
背景 阴道微生物失调，即菌群间的失衡，可引发免疫和代谢信号的一些局部变化，导致慢性炎症。人乳头瘤病毒（HPV）感染清除或进展的机制尚未明确。我们推测阴道微生物失调可能与宫颈HPV感染的持续存在有关。因此，我们旨在确定乳酸杆菌优势指数与宫颈高危型HPV持续感染之间的关联。方法 共有100名因高危型HPV感染而接受随访的女性被定义为目标研究组。患者被分为两组进行评估；HPV阳性组（HPV持续感染组，n = 43）和HPV阴性组（HPV清除组，n = 57）。对宫颈阴道拭子样本和血液样本进行Nugent评分、乳酸杆菌优势度及白细胞计数评估。使用IBM统计产品与服务解决方案（版本22，适用于Windows的IBM SPSS Statistics，纽约州阿蒙克）程序进行统计检验。连续变量以均值±标准差（SD）表示，分类变量以病例数及其百分比表示。设定p值小于0.05（<0.05）为具有统计学意义。结果 43名（43%）患者出现HPV持续感染。单因素分析显示，年龄、绝经状态和乳酸杆菌减少与HPV持续感染有关（p<0.05）。各组间Nugent评分的中位数相似。经逻辑回归分析后，乳酸杆菌减少仍与HPV持续感染有关，且独立于年龄和绝经状态（比值比：2.668，96%可信区间：1.069 - 6.662，p<0.05）结论 在本研究中，无论年龄和绝经状态如何，宫颈阴道微生物群中乳酸杆菌的减少与HPV的持续感染有关。
