Bacterial vaginosis is significantly associated with a higher risk of high-risk human papillomavirus persistence: a cohort study in Nairobi, Kenya

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Background Reasons why some human papillomavirus infections persist while others spontaneously resolve remain elusive. There is speculation that bacterial vaginosis increases the likelihood of high-risk human papillomavirus persistence. However, the magnitude of the risk it imposes on human papillomavirus infected women, which influences persistence, remains unclear. The objective of this study was to determine whether bacterial vaginosis is associated with a higher risk of persistent high-risk human papillomavirus infection among women. Methods A total of 498 women were recruited at baseline, and of these, 97 women with a current human papillomavirus infection were enrolled into two cohorts, classified by baseline bacterial vaginosis status. The women were retested for both infections after 24 months. Results The persistence of high-risk human papillomavirus was more common in women with baseline bacterial vaginosis ( p = 0.01), and type HPV-52 was the most persistent genotype. The risk of persistence was 1.38 times greater among women with baseline bacterial vaginosis than among those without. Multivariate logistic regression analysis revealed that BV resolution influenced whether HPV persisted or was cleared in this study (aOR = 5.40, 95%CI = 2.24–13.07; p = 0.002). Conclusion These findings indicate greater biological susceptibility to high-risk human papillomavirus persistence among women with bacterial vaginosis. This result highlights the significance of effectively treating BV when it occurs, as doing so may assist in reducing the risk of hr-HPV persistence.

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