Meta Analysis Of The Correlation Between Vaginal Microecology And HPV Infection

Background and objective:Human papilloma virus(HPV)is a common double-stranded DNA virus associated with the development of various types of benign and malignant tumors in humans.So far,more than 200 HPV types has been identified,many of which are transmitted during sexual contact.Vaginal microecology is a dynamic microecosystem composed of normal colonizing flora,host immunity,periodic endocrine changes and cervical-vaginal anatomical structure.The cervix is exposed to this complex environment.Once the vaginal microecosystem is out of balance,the risk of cervical lesions will increase,as well as the risk of invasion of various microorganisms,viruses and other organisms.With the deepening of microbial and microecological studies,vaginal microecology has been gradually paid attention to by scholars.A large number of research evidence shows that changes in vaginal microecology affect HPV infection.Therefore,understanding the relationship between HPV and vaginal microenvironment is of great significance for HPV prevention and treatment.In this paper,the correlation between vaginal microecology and HPV infection was studied through meta-analysis,in order to provide some guidance for future clinical treatment.Methods:We search CNKI,Pubmed,Wanfang database,Embase,etc.,and search the whole articles from the database built to the December 2019.According to the inclusion and exclusion criteria,we chose 25 articles having 20520 patients.We devide the patients into two groups: the experimental group and the control group.Experimental group for HPV positive and control group for HPV negative,each group includes bacterial vaginosis(BV),vaginal yeast infection(VVC),trichomonas vaginitis(TV),Ureaplasma urealyticum(UU),Chlamydia Trachomas(CT),PH>4.5,CD4+T?CD8+T and CD4+T/CD8+T.We extract into research groups of data,using Revman 5.3 do the meta analysis.Results:The results of this meta-analysis: the risk of HPV infection in BV positive patients was 1.87 times than that in BV negative patients,with 95%CI [1.37,2.57];the correlation analysis between VVC and HPV infection was not significant,and the OR=1.05,95%CI [0.89,1.23].the TV positive correlation between HPV infection and analysis of consolidation effect OR=1.90,95%CI [1.22,2.96],TV for HPV infection was significant(P< 0.05).UU positive associated with HPV infection was2.03 times that of UU negative patients,95%CI [1.02,4.02];CT positive patients are prone to HPV infection OR=4.00,95%CI [1.86,8.60],P=0.0004;PH> 4.5 was significantly associated with HPV infecction,and the results was OR=3.80,95%CI[3.14,4.59],P<0.00001.Correlation analysis results of HPV persistent infection with BV were OR=1.91,95%CI [1.60,2.28],P<0.00001,the difference between the two groups was significant.Correlation analysis results of HPV persistent infection with H2O2 deficiency was analyzed as OR=2.37,95%CI [1.01,5.56],P=0.05,indicating a statistically significant difference between the two groups.The correlation between HPV persistent infection and leucocyte lipase positive results was analyzed by OR=1.45,95%CI[0.56,3.75],P=0.45.The difference between the two groups was not significant.This indicateween that positive BV and lactobacillus deficiency will promote HPV infection.But there is no obvious correlation with local cervical inflammation.Results of correlation analysis between HPV persistent infection and local cervical CD4+T cells MD=-6.57,95%CI[8.72,4.42],P<0.00001,the difference between two groups was significant.Results analysis of the correlation between HPV sustained infection and local cervical CD8+T cells MD=1.55,95%CI[-1.79,4.89],P=0.36,and the difference between two groups was not significant.Results analysis of the correlation between HPV sustained infection and local cervical CD4+T/CD8+T cells MD=-0.39,95%CI[-0.48,-0.30],P< 0.00001,the difference between two groups was significant.This indicating that the local immunity reduction in the cervix of patients with persistene HPV infention would promote thepersistent HPV infection and reduce the clearance rate of HPV.The sensitivity analysis of th above outcomes shows that the results are raliable.Conclusions:1.Maintaining the normal vaginal micro-ecological enviroment and early intervention of infectious vaginosis may enhance the local immune clearance of the body,which may have a positive effect on clearning HPV infection and preventing cervical lesions.2.BV is associated with HPV infection,which not only increase HPV infection,but also promotes persistent HPV infection.3.Abnormal vaginal PH and reduced lactobacillus will increase the risk of HPV infecton.The application of lactobacillus,suitable for the application of PH vaginal rinse solution may have an important role in removing HPV infection.4.TV,UU,CT were strongly correlated with infection of HPV,while VVC may increase the changce of HPV infection.5.Local CD4+T and CD8+T cells of the cervix are rucial for the prevention and clearance of HPV infection.Local low immunity of the cervix will reduce the clearance rate of HPV and lead to the occurrence of persistent HPV infection.