A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection.
A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection.
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DOI：
10.1186/1471-2334-12-33
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发表时间：
2012-02-08
影响因子：
3.7
通讯作者：
Schiffman M
中科院分区：
文献类型：
--
作者：
Clarke MA;Rodriguez AC;Gage JC;Herrero R;Hildesheim A;Wacholder S;Burk R;Schiffman M
阴道 pH 值与生殖道炎症和细菌菌群变化有关，两者均表明是人乳头瘤病毒 (HPV) 感染持续存在的辅助因素。为了评估阴道 pH 值与 HPV 之间的关系，我们分析了哥斯达黎加瓜纳卡斯特大规模人群研究的数据。我们检查了阴道 pH 值以及 HPV 感染、细胞学异常和沙眼衣原体感染的风险。我们的研究纳入了 9,165 名年龄在 18-97 岁之间的女性，总共进行了 28,915 次就诊（平均随访时间 = 3.4 年）。使用广义估计方程来评估阴道 pH 值与 HPV 感染（整体和单一与多种类型）以及低度鳞状上皮内病变（LSIL）（HPV 感染的细胞形态表现）之间的关系。通过逻辑回归评估入组阴道 pH 值与沙眼衣原体感染之间的关系。结果按访视时的年龄进行分层。 HPV 检测与阴道 pH 值呈正相关，主要发生在 < 35 岁的女性中（对于年龄 < 25 岁和 25-34 岁的女性，p 趋势分别 = 0.009 和 0.007）。阴道 pH 值升高与多种 HPV 类型和 LSIL 感染的风险增加 30% 相关，主要发生在 35 岁以下和 65 岁以上的女性中。沙眼衣原体 DNA 的检测与 25 岁以下女性阴道 pH 值升高相关（OR 2.2 95% CI 1.0-5.0）。我们的研究结果表明，宫颈微环境可能是宫颈癌前病变和癌症发展中 HPV 自然史的调节剂。未来的研究应包括对阴道 pH 值的研究，以对激素变化和宫颈阴道微生物组进行更复杂的评估，因为它们与宫颈肿瘤的自然史有关。
Vaginal pH is related to genital tract inflammation and changes in the bacterial flora, both suggested cofactors for persistence of human papillomavirus (HPV) infection. To evaluate the relationship between vaginal pH and HPV, we analyzed data from our large population-based study in Guanacaste, Costa Rica. We examined vaginal pH and the risk of HPV infection, cytological abnormalities, and C. trachomatis infection. Our study included 9,165 women aged 18-97 at enrollment with a total of 28,915 visits (mean length of follow-up = 3.4 years). Generalized estimating equations were used to evaluate the relationship between vaginal pH and HPV infection (both overall and single versus multiple types) and low-grade squamous intraepithelial lesions (LSIL), the cytomorphic manifestation of HPV infection. The relationship between enrollment vaginal pH and C. trachomatis infection was assessed by logistic regression. Results were stratified by age at visit. Detection of HPV was positively associated with vaginal pH, mainly in women < 35 years (p-trend = 0.009 and 0.007 for women aged < 25 and 25-34 years, respectively). Elevated vaginal pH was associated with 30% greater risk of infection with multiple HPV types and with LSIL, predominantly in women younger than 35 and 65+ years of age. Detection of C. trachomatis DNA was associated with increased vaginal pH in women < 25 years (OR 2.2 95% CI 1.0-5.0). Our findings suggest a possible association of the cervical microenvironment as a modifier of HPV natural history in the development of cervical precancer and cancer. Future research should include studies of vaginal pH in a more complex assessment of hormonal changes and the cervicovaginal microbiome as they relate to the natural history of cervical neoplasia.
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DOI：
10.1016/s0002-9378(99)70595-8
发表时间：
1999-05-01
影响因子：
9.8
作者：
García-Closas, M;Herrero, R;Schiffman, M
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DOI：
10.1016/s0002-9378(97)70345-4
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1997-06-01
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Roy, S
DOI：
10.1016/0002-9378(95)91491-9
发表时间：
1995-04-01
影响因子：
9.8
作者：
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影响因子：
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