Clinical analysis of association between vaginal microbiota indicators and HPV infection

Objective To investigate the correlation between vaginal microbiota indicators and HPV infection, providing a reference for clinical prevention and treatment of HPV-related diseases. Methods Clinical data of 5,362 female patients who underwent vaginal microbiota testing and HPV detection were retrospectively analyzed. The distribution of vaginal microbiota indicators and their association with HPV infection were statistically analyzed using the chi-square test. Three hundred fifty-five patients infected with HPV 16/18 were enrolled, followed up their HPV re-detection results at 12 months, and performed univariate analysis and logistic regression analysis to identify the risk factors for persistent HPV infection. Results Among the 5,362 subjects, the positive rates of hydrogen peroxide, sialidase, leukocyte esterase, Trichomonas vaginalis, mold, and clue cells were 96.38%, 16.51%, 59.29%, 0.93%, 16.09%, and 8.65% respectively. 63.19% of the subjects had vaginal cleanliness of III-IV, and 71.73% had a vaginal pH value >4.5. Statistical analysis showed that sialidase ( χ 2 = 4.13, P = 0.04), and vaginal cleanliness ( χ 2 = 8.32, P = 0.00) were significantly associated with HPV infection; Vaginal Cleanliness( χ 2 = 8.32, P = 0.04) and pH( χ 2 = 14.63, P = 0.00) were significantly associated with HPV Genotypes. Vaginal pH value (OR = 2.65, 95% CI: 1.55–4.52, P < 0.001), N-acetylglucosaminidase positive (OR = 2.14, 95% CI: 1.12–4.08, P = 0.021), and fungus detected (OR = 1.88, 95% CI: 1.06–3.35, P = 0.032) were identified as independent risk factors for persistent HPV infection. Conclusion Vaginal microbiota imbalance, as indicated by abnormal sialidase, poor vaginal cleanliness, and elevated pH value, may be related to HPV infection. Vaginal pH value, N-acetylglucosaminidase positive and fungus detected were identified as independent risk factors for persistent HPV infection.