Genital tract infections not a risk factor for cytologic abnormalities regardless of HPV infection status

Neither vulvovaginal candidiasis nor bacterial vaginosis is associated with increased incidence of cervical cytologic abnormalities among women with or without human papillomavirus (HPV) infection, according to a study. Bacterial vaginosis may even have a protective effect against cytologic abnormalities among women with HPV coinfection.

For the study, researchers examined whether genital tract infection in women had an additional effect on HPV infection and thus caused cervical cytologic abnormalities. A total of 14,679 women (mean age 36 years) underwent HPV DNA and ThinPrep cytologic tests to detect cytologic abnormalities (eg, atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, atypical squamous cells, and squamous cell carcinoma), vulvovaginal candidiasis, and bacterial vaginosis.

A total of 982 women (6.69 percent) were positive for cytologic abnormalities. Bacterial vaginosis infection rates were significantly higher among women in the cytology-negative group than in the cytology-positive group (p=0.003) and among those with vs without HPV infection (p<0.001).

Multivariable analysis showed a protective association between bacterial vaginosis and cytologic abnormalities among all women (model 1: odds ratio [OR] 0.36; model 2: OR, 0.17; p<0.05) and among those with HPV infection (model 1: OR, 0.17; model 2: OR, 0.16; p<0.05).

Meanwhile, vulvovaginal candidiasis with or without HPV coinfection had no significant association with the incidence of cytologic abnormalities (p>0.05).