Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis

Medline and Web of Science were systematically searched for eligible publications until December 2009. Articles were selected based on inclusion and exclusion criteria. After testing heterogeneity of studies, meta-analysis was performed using random effect model.Twelve eligible studies were selected to review the association between BV and HPV, including a total of 6,372 women. The pooled prevalence of BV was 32%. The overall estimated odds ratio (OR) showed a positive association between BV and cervical HPV infection (OR, 1.43; 95% confidence interval, 1.11-1.84).This meta-analysis of available literature resulted in a positive association between BV and uterine cervical HPV infection.Bacterial vaginosis (BV) is the most prevalent cause of abnormal vaginal discharge, affecting women of reproductive age [1]. This infestation is characterized by a loss of indigenous (hydrogen peroxide-producing) Lactobacillus-predominant vaginal microflora, and a concurrent massive overgrowth of anaerobic bacteria. The most common include Gardnerella vaginalis, Mobiluncus species, Prevotella species, Mycoplasma hominis and Atopobium vaginae [2]. At least 50% of patients have no symptoms [3]. In the other half, it most often manifests clinically as a thin homogenous vaginal discharge, a vaginal pH of more than 4.5, presence of 'clue cells', and an amine odour after addition of 10% of potassium hydroxide [1,2].The etiopathogenesis of this condition remains subject of debate. Some risk factors have been associated with BV, including cigarette smoking, use of intrauterine devices, frequent vaginal douches, multiple sexual partners, early age at first intercourse, and black ethnicity [4,5]. BV has been shown to increase the risk of obstetric and gynaecologic complications such as preterm labour and delivery, chorioamnionitis, post-caesarean endometritis, postabortion pelvic inflammatory disease, and cervicitis [6,7]. Moreover, BV has been associated with many sexually transmitted infectio