Association between Vaginal Infections and the Types and Viral Loads of Human Papillomavirus: A Clinical Study Based on 4,449 Cases of Gynecologic Outpatients.

OBJECTIVE: We here evaluated the association between human papillomavirus (HPV) infection and vaginal infections, including bacterial vaginosis (BV), trichomonas vaginalis (TV), and vulvovaginal candidiasis (VVC). METHODS: A total of 4,449 women were enrolled in this study and given gynecological examinations. HPV genotyping and viral load determination were performed using a real-time PCR. Vaginal infections were diagnosed using wet mounts of vaginal secretions, gram-stained vaginal secretion smears, and chemical enzyme kits. RESULTS: In this study, the overall HPV-positive rate was 25.06%, and vaginal infection tended to occur in women with HPV infection (P < 0.05). HPV infection tended to occur in BV- and TV-positive women (P < 0.05) and not in women with microecological disorders, intermediate type BV, VVC, or coinfection (P > 0.05). The most common genotypes were HPV58 and HPV53 in women with normal vaginal microecology and HPV16 and HPV52 in the women suffering from vaginal infection. The viral loads among groups for HPV16 and HPV52 showed no statistically significant differences (P=0.940; P=0.167). CONCLUSIONS: Our study revealed that BV and TV are associated with HPV infection, especially high-risk HPV infection, while VVC has no association with HPV infection. Further studies are needed to explore the detailed mechanism.

Association between viral loads of different oncogenic human papillomavirus types and the degree of cervical lesions in the progression of cervical Cancer.

OBJECTIVE: In this study we determined the frequency of the most prevalent human papillomavirus (HPV) types in China and evaluated the association between viral loads of different oncogenic HPV types and the severity of disease. METHODS: We enrolled 15,518 women for this study and 3199 of them (20.61%) were identified as positive by a PCR assay, that can simultaneously quantify and genotype HPV. RESULTS: The viral loads of HPV 16, 31, 35, 52, 58, 39, and 56 were lower for women with normal cytology compared to those with disease progression; viral loads were not appreciable for HPV 33, 18, 45, 59, 68, 53, 66, and 51. The viral load of species 9 appeared significantly higher for women with cervical intraepithelial neoplasia (CIN) 2/CIN 3 relative to women with normal/low grade squamous intraepithelial lesion (LSIL)/CIN1 (P < 0.001), and significantly lower compared to those with cervical cancer (P < 0.001). The viral load of HPV species 6 was slightly higher for women with CIN2/CIN 3 compared to women with normal/LSIL/CIN1 (P = 0.002), and not significantly different from women with cervical cancer (P = 0.548). In addition, no statistically significant difference was found in HPV species 5 or species 7 (P = 0.898; P = 0.136). CONCLUSIONS: The HPV viral load-associated risk for developing into CIN and cervical cancer is likely to be species-dependent and primarily restricted to species 9 (types phylogenetically close to HPV16).