Abstract
BACKGROUND AND OBJECTIVES: This study investigated the correlation between high-risk (HR) human papillomavirus (HPV), sexually transmitted disease (STD), and vaginal microbiota in patients with a normal Pap smear. MATERIALS AND METHODS: For women who were referred for their routine cervical cancer screening, in addition to co-testing, some samples were taken from the vaginal and cervical environment to check the presence of the most common STD pathogens. The diagnosis of the organisms was done by means of PCR and microbial cultures. RESULTS: HR HPV was detected in 67 women, and STD was positive in 80% of them, while in HR HPV negative women, this was 67%. The HPV positive group reported a significantly higher rate of STD history (92% vs. 82%) and frequency of intercourse weekly (86% vs. 3.96%) (p<0.05). Lactobacilli, streptococcus, and staphylococcus concentrations were significantly lower in the HPV positive group compared to the HPV negative group (p<0.007; OR = 4.17). Ureaplasma urealyticum and Ureaplasma parvum were significantly (p<0.001) more prevalent in the HPV positive group compared to the HPV negative group. CONCLUSION: This study showed that the existence of other STDs and the composition of the vaginal and cervical microbiome play an important role in either the clearance or the progression of high-risk HPV.