Bacterial vaginosis and cervical human papillomavirus infection in young and adult women: a systematic review and meta-analysis

ABSTRACT OBJECTIVE To investigate the association between bacterial vaginosis and cervical human papillomavirus (HPV) infection in young and adult women. METHODS This systematic review and meta-analysis was based on the Prisma methodological guidelines. PubMed and Web of Science were searched using the following descriptors: “bacterial vaginosis and HPV”, in June 2019. Articles published from 2012 to 2019 were included. Inclusion criteria were original studies that investigated the association between bacterial vaginosis and cervical HPV infection; articles published in English, Spanish or Portuguese; studies conducted in young and adult, non-pregnant, non-HIV-infected women; studies that used the Nugent criteria for the diagnosis of bacterial vaginosis and studies in which the detection of HPV used the polymerase chain reaction technique. Assembled data, odds ratio (OR) and respective 95% confidence intervals (95%CI) were estimated for the association between bacterial vaginosis and cervical HPV infection using random-effects models. A bilateral value of p < 0.05 was considered statistically significant. RESULT Six studies were selected for analysis and demonstrated association between bacterial vaginosis and cervical HPV infection (OR = 2.68; 95%CI: 1.64–4.40; p < 0.001). CONCLUSION Bacterial vaginosis was considered a risk factor for cervical HPV infection, since women with bacterial vaginosis were more likely to be infected with HPV.

摘要
研究目的：探究青年及成年女性细菌性阴道病（bacterial vaginosis）与宫颈人乳头瘤病毒（HPV）感染之间的关联。
研究方法：本项系统评价与荟萃分析遵循PRISMA方法学指南开展。本研究于2019年6月以"细菌性阴道病与HPV"为检索词检索PubMed及Web of Science数据库，纳入2012年至2019年发表的相关文献。纳入标准如下：探究细菌性阴道病与宫颈HPV感染关联的原创研究；以英语、西班牙语或葡萄牙语发表的文献；针对青年及成年非妊娠、非HIV感染女性开展的研究；采用努根特标准（Nugent criteria）诊断细菌性阴道病的研究；以及采用聚合酶链反应（polymerase chain reaction, PCR）技术检测HPV的研究。采用随机效应模型对细菌性阴道病与宫颈HPV感染的关联进行数据合并，计算比值比（OR）及其对应的95%置信区间（95%CI），以双侧检验P<0.05为具有统计学意义的判定标准。
研究结果：最终纳入6项研究进行分析，结果显示细菌性阴道病与宫颈HPV感染存在显著关联（OR=2.68；95%CI：1.64~4.40；P<0.001）。
研究结论：细菌性阴道病可被视为宫颈HPV感染的危险因素，即合并细菌性阴道病的女性感染HPV的风险更高。