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Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis

Gillet E, Meys JF, Verstraelen H, Bosire C, De Sutter P, Temmerman M, Broeck DV - BMC Infect. Dis. (2011)

Bottom Line: Articles were selected based on inclusion and exclusion criteria.After testing heterogeneity of studies, meta-analysis was performed using random effect model.The pooled prevalence of BV was 32%.

Affiliation: International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.

ABSTRACT

Background: Bacterial vaginosis (BV), an alteration of vaginal flora involving a decrease in Lactobacilli and predominance of anaerobic bacteria, is among the most common cause of vaginal complaints for women of childbearing age. It is well known that BV has an influence in acquisition of certain genital infections. However, association between BV and cervical human papillomavirus (HPV) infection has been inconsistent among studies. The objective of this meta-analysis of published studies is to clarify and summarize published literature on the extent to which BV is associated with cervical HPV infection.

Methods: Medline and Web of Science were systematically searched for eligible publications until December 2009. Articles were selected based on inclusion and exclusion criteria. After testing heterogeneity of studies, meta-analysis was performed using random effect model.

Results: Twelve eligible studies were selected to review the association between BV and HPV, including a total of 6,372 women. The pooled prevalence of BV was 32%. The overall estimated odds ratio (OR) showed a positive association between BV and cervical HPV infection (OR, 1.43; 95% confidence interval, 1.11-1.84).

Conclusion: This meta-analysis of available literature resulted in a positive association between BV and uterine cervical HPV infection.

Forest plot of estimates of association between bacterial vaginosis and cervical human papillomavirus infection. Studies are identified by references. Each study is represented by a black square and a horizontal line, which corresponds to the estimate (ES) and 95% confidence interval (CI) of odds ratios. Area of black squares reflects weight of study in the meta-analysis.
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Figure 2: Forest plot of estimates of association between bacterial vaginosis and cervical human papillomavirus infection. Studies are identified by references. Each study is represented by a black square and a horizontal line, which corresponds to the estimate (ES) and 95% confidence interval (CI) of odds ratios. Area of black squares reflects weight of study in the meta-analysis.

Mentions: Analysis of the association between BV and cervical HPV infection shows that HPV prevalence is significantly higher in BV positive women in only three out of twelve studies compared to women without BV [14,17,23]. Figure 2 represents reported odds ratios with their 95% CI for the likelihood of detecting cervical HPV in presence of BV, weight given to each study in random effects model, and combined odds ratio with 95% CI. Odds ratios in different studies ranged from 0.60 [13] to 6.42 [14]. The combined odds ratio for included cross-sectional studies was 1.43 (95% CI, 1.11-1.84, p = 0.005), indicating a positive association between BV and cervical HPV infection.

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Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis

Gillet E, Meys JF, Verstraelen H, Bosire C, De Sutter P, Temmerman M, Broeck DV - BMC Infect. Dis. (2011)

Forest plot of estimates of association between bacterial vaginosis and cervical human papillomavirus infection. Studies are identified by references. Each study is represented by a black square and a horizontal line, which corresponds to the estimate (ES) and 95% confidence interval (CI) of odds ratios. Area of black squares reflects weight of study in the meta-analysis.
© Copyright Policy - open-access
Figure 2: Forest plot of estimates of association between bacterial vaginosis and cervical human papillomavirus infection. Studies are identified by references. Each study is represented by a black square and a horizontal line, which corresponds to the estimate (ES) and 95% confidence interval (CI) of odds ratios. Area of black squares reflects weight of study in the meta-analysis.
Mentions: Analysis of the association between BV and cervical HPV infection shows that HPV prevalence is significantly higher in BV positive women in only three out of twelve studies compared to women without BV [14,17,23]. Figure 2 represents reported odds ratios with their 95% CI for the likelihood of detecting cervical HPV in presence of BV, weight given to each study in random effects model, and combined odds ratio with 95% CI. Odds ratios in different studies ranged from 0.60 [13] to 6.42 [14]. The combined odds ratio for included cross-sectional studies was 1.43 (95% CI, 1.11-1.84, p = 0.005), indicating a positive association between BV and cervical HPV infection.

Bottom Line: Articles were selected based on inclusion and exclusion criteria.After testing heterogeneity of studies, meta-analysis was performed using random effect model.The pooled prevalence of BV was 32%.

Affiliation: International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.

ABSTRACT

Background: Bacterial vaginosis (BV), an alteration of vaginal flora involving a decrease in Lactobacilli and predominance of anaerobic bacteria, is among the most common cause of vaginal complaints for women of childbearing age. It is well known that BV has an influence in acquisition of certain genital infections. However, association between BV and cervical human papillomavirus (HPV) infection has been inconsistent among studies. The objective of this meta-analysis of published studies is to clarify and summarize published literature on the extent to which BV is associated with cervical HPV infection.

Methods: Medline and Web of Science were systematically searched for eligible publications until December 2009. Articles were selected based on inclusion and exclusion criteria. After testing heterogeneity of studies, meta-analysis was performed using random effect model.

Results: Twelve eligible studies were selected to review the association between BV and HPV, including a total of 6,372 women. The pooled prevalence of BV was 32%. The overall estimated odds ratio (OR) showed a positive association between BV and cervical HPV infection (OR, 1.43; 95% confidence interval, 1.11-1.84).

Conclusion: This meta-analysis of available literature resulted in a positive association between BV and uterine cervical HPV infection.

View Similar Images In: Results  - Collection
View Article: MedlinePlus - PubMed Central - HTML -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=3023697&rFormat=json&query=the&fields=all&favor=none&it=none&sp=none&sub=none&uniq=0&req=5