Author: Chen Yan (Affiliated Hospital of North China University of Science and Technology)
High-risk human papillomavirus (HPV) is a key factor in inducing cervical precancerous lesions and cervical cancer.
Early screening for high-risk HPV has become an important means of preventing cervical cancer.
How do HPV infections and vaginitis interact?
Most often, HPV is transmitted through sexual activity. Once infected with high-risk HPV, patients often have vaginal dysbiosis, decreased immune function, resulting in vaginal inflammation, and under the joint action of a variety of factors, it is easy to cause cervical cancer.
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Specific manifestations are:
Under normal circumstances, Lactobacillus is in a dominant position in the vagina, which can inhibit the invasion of pathogens, activate the immune system of the vaginal mucosa, and remove pathogenic bacteria in time, thereby maintaining the microecological balance in the vagina and enhancing the local anti-infection and anti-tumor ability of the vagina.
When infected with HPV, especially high-risk HPV, intravaginal lactobacillus growth is inhibited. The decrease of lactobacilli causes the proliferation of pathogenic microorganisms such as Chlamydia, Mycoplasma urealyticus, Anaerobic Bacteria, and Gardnerella, resulting in vaginal flora disorders.
Vaginal dysbacteriosis can enhance the expression of the HPV virus, which eventually leads to cervical cell lesions.
And pathogenic microorganisms can cause inflammatory reactions, resulting in damage to vaginal mucosal epithelial cells, which in turn increases HPV susceptibility, continuous infection occurs, coupled with the carcinogenic effect of nitrosoamines produced by the metabolism of various anaerobic bacteria, thereby accelerating the transformation of cervical epithelial cells and further increasing the risk of cervical cancer.
Therefore, for patients who have been infected with HPV, it can be considered to supplement the vagina with lactobacilli, inhibit the growth of pathogenic bacteria, improve the vaginal environment, restore the balance of vaginal microecology, and increase their ability to clear HPV.
Second, HPV infection is associated with bacterial vaginosis
In addition, analysis confirms that HPV infection is associated with bacterial vaginosis (BV)[1].
Patients with BV present with a large proliferation of intravaginal Gardnerella and a variety of anaerobic bacteria, inhibiting the growth of lactobacillus, reducing the local anti-infection ability of the vagina, and can lead to the occurrence of persistent HPV infection.
There are also studies suggesting that Mycoplasma infection may play a role in high-risk HPV infection [2].
Therefore, once BV and Mycoplasma infection occurs, aggressive treatment is required to prevent HPV infection.
In summary, HPV infection is closely associated with vaginal dysbacteriosis. Of course, whether dysbacteriosis is the cause or consequence of persistent HPV infection remains to be explored.
bibliography:
The correlation between HPV infection and BV, VVC and TV is based on the clinical study of 1261 gynecological outpatients[J].Chinese Journal of Obstetrics and Gynecology,2016,51(10):730-733.
He Tao,Cai Xiaolei,Sun Zongli,et al. Correlation between Mycoplasma urealyticae infection and cervical cancer in high-risk HPV-positive patients[J].Shandong Medicine, 2013, 53(32):38-40.
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