ArticleBMC infectious diseases2026
A retrospective analysis of the correlation between vaginal microecology and high-risk HPV infection among 5727 women.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo explore the association between vaginal microecological status and high-risk human papillomavirus (HR-HPV) infection, providing large-sample evidence for HR-HPV prevention/control and vaginal microecological imbalance intervention.
methodsClinical data of 5,727 women who underwent both HR-HPV and vaginal microecology testing in the Clinical Laboratory of the South Campus of Shanghai East Hospital (January 2023-November 2025) were retrospectively analyzed. Participants were divided into HR-HPV-positive (n = 503, 8.78%) and negative (n = 5,224, 91.22%) groups. Core microecological indicators (Lactobacillus abundance, pathogenic microorganisms, epithelial cells, etc.) were compared by chi-square test. Univariate and multivariate regression analyses were performed with HR-HPV positivity, HPV16 positivity, and HPV18/45 positivity as outcomes, incorporating 10 independent variables.
resultsCompared with the HR-HPV-negative group, the positive group had significantly higher proportions of vaginal cleanliness grades Ⅲ (22.47%) and Ⅳ (20.87%) (χ²=22.25, P < 0.001), intermediate bacterial vaginosis (BV, 42.94%) and BV (10.74%) (χ²=32.87, P < 0.001), as well as mild aerobic vaginitis (AV, 28.63%) and severe AV (0.99%) (χ²=8.314, P < 0.05). Significant differences were also observed in miscellaneous bacteria positive rate (89.07%), clue cell positive rate (8.15%), and epithelial cell (2 + and 4+) proportion (28.23%) (χ²=45.82, 11.09, 11.34; all P < 0.05). Univariate analysis identified 7 significant variables for HR-HPV infection, and multivariate analysis confirmed 5 independent factors (age, Lactobacilli, epithelial cells, miscellaneous bacteria, white blood cells). Age and miscellaneous bacteria were associated with HPV16 infection, while Lactobacillus levels were significantly associated with HPV18/45 infection.
conclusionLarge-sample analysis confirms that HR-HPV infection is closely associated with vaginal microecological imbalance, mainly manifested by abnormal bacterial and fungal proliferation. Vaginal microecological disorder may be a risk factor for HR-HPV infection, and its regulation can assist in HR-HPV prevention and treatment. CLINICAL TRIAL NUMBER: Not applicable.
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