Meta-analysis of the correlation between vaginal microenvironment and HPV infection

Purpose: To study the correlation between the vaginal microenvironment and human papillomavirus (HPV) infection by meta-analysis. Methods: Databases including the Chinese Journal Full-text Database, China Science and Technology Journal, Wanfang, PubMed, Embase, Cochrane, and Web of Science were used to comprehensively retrieve published clinical studies on the correlation between the vaginal microenvironment and HPV infection. The retrieval was performed according to the inclusion and exclusion criteria, then qualified clinical studies were included for quality evaluation and data extraction. Revman 5.3 software was used for meta-analysis. The correla-tion between the vaginal microenvironment and HPV infection was assessed. The statistical results were shown by forest plots. Publication bias was tested by funnel plot. Results: Ten independent studies were included in this study, involving 11,649 patients. The meta-analysis results showed that compared with the HPV-negative group, the HPV-positive group had a significant increase in the aerobic vaginitis (OR = 1.73, 95% CI: 1.19-2.50, P = 0.004), bacterial vaginosis (OR = 2.52, 95% CI: 1.78-3.57, P < 0.001) and trichomonal vaginitis (OR = 1.60, 95% CI: 1.27-2.02, P < 0.001) infection rates, while there was no substantial difference in the vulvovaginal candidiasis infection rate between two groups (OR = 1.48, 95% CI: 0.99-2.23, P = 0.06). Conclusion: The vaginal microenvironment is closely related to HPV infection, especially aerobic vaginitis, bacterial vaginosis and trichomonal vaginitis are high-risk factors for HPV infection.