Association between Common Vaginal Infections and Cervical Non-HPV16/18 Infection in HPV-Vaccinated Women.

BACKGROUND How vaginal infections like bacterial vaginosis (BV), Candida spp., and Trichomonas vaginalis (TV) affect persistence of human papillomavirus (HPV) infection is not well established. Our study aimed to evaluate the association between common vaginal infections and cervical non-HPV16/18 infection, as risk factors associated with persistence of non-vaccine HPV types will become increasingly relevant in the setting of HPV vaccination. METHODS We performed an analysis in 2,039 AS04-HPV16/18-vaccinated women enrolled in a phase II/III trial in China, who were HPV DNA-negative at Month 0 and 6 and had at least one subsequent follow-up visit. Vaginal infections were detected in liquid-based cytology according to the diagnostic criteria of The Bethesda System. Associations between vaginal infections and incident and 6-month persistent non-HPV16/18 infections in the cervix were evaluated using generalized estimating equations, adjusting for the age at initial vaccination, as well as HPV types in the persistence analysis. RESULTS Study visits with any vaginal infection had a statistically significant increased risk of incident non-HPV16/18 infection compared to those without vaginal infections(OR:1.44,95%CI:1.09-1.92). However, vaginal infections were not associated with 6-month persistent non-HPV16/18 infection (OR:1.02,95%CI:0.62-1.69). CONCLUSIONS Our study suggests that common vaginal infections are not associated with persistence of non-HPV16/18 infection among HPV16/18-vaccinated women.