A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection
<p>Abstract</p> <p>Background</p> <p>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 ana...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-02-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2334/12/33 |
| _version_ | 1818662537959309312 |
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| author | Clarke Megan A Rodriguez Ana Gage Julia C Herrero Rolando Hildesheim Allan Wacholder Sholom Burk Robert Schiffman Mark |
| author_facet | Clarke Megan A Rodriguez Ana Gage Julia C Herrero Rolando Hildesheim Allan Wacholder Sholom Burk Robert Schiffman Mark |
| author_sort | Clarke Megan A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>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 <it>C. trachomatis </it>infection.</p> <p>Methods</p> <p>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 <it>C. trachomatis </it>infection was assessed by logistic regression. Results were stratified by age at visit.</p> <p>Results</p> <p>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 <it>C. trachomatis </it>DNA was associated with increased vaginal pH in women < 25 years (OR 2.2 95% CI 1.0-5.0).</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-12-17T05:02:32Z |
| format | Article |
| id | doaj.art-f6188f7b1f4a4ae2bc5409b71c477fdd |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T05:02:32Z |
| publishDate | 2012-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-f6188f7b1f4a4ae2bc5409b71c477fdd2022-12-21T22:02:31ZengBMCBMC Infectious Diseases1471-23342012-02-011213310.1186/1471-2334-12-33A large, population-based study of age-related associations between vaginal pH and human papillomavirus infectionClarke Megan ARodriguez AnaGage Julia CHerrero RolandoHildesheim AllanWacholder SholomBurk RobertSchiffman Mark<p>Abstract</p> <p>Background</p> <p>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 <it>C. trachomatis </it>infection.</p> <p>Methods</p> <p>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 <it>C. trachomatis </it>infection was assessed by logistic regression. Results were stratified by age at visit.</p> <p>Results</p> <p>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 <it>C. trachomatis </it>DNA was associated with increased vaginal pH in women < 25 years (OR 2.2 95% CI 1.0-5.0).</p> <p>Conclusions</p> <p>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.</p>http://www.biomedcentral.com/1471-2334/12/33HPVVaginal pHCervical neoplasiaAgingChlamydia |
| spellingShingle | Clarke Megan A Rodriguez Ana Gage Julia C Herrero Rolando Hildesheim Allan Wacholder Sholom Burk Robert Schiffman Mark A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection BMC Infectious Diseases HPV Vaginal pH Cervical neoplasia Aging Chlamydia |
| title | A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection |
| title_full | A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection |
| title_fullStr | A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection |
| title_full_unstemmed | A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection |
| title_short | A large, population-based study of age-related associations between vaginal pH and human papillomavirus infection |
| title_sort | large population based study of age related associations between vaginal ph and human papillomavirus infection |
| topic | HPV Vaginal pH Cervical neoplasia Aging Chlamydia |
| url | http://www.biomedcentral.com/1471-2334/12/33 |
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