Recurrent vaginal biocenotic disorders associated with bacterial vaginosis in pregnant women with HPV infection

Objective. To determine the rate of recurrent vaginal biocenotic disorders associated with bacterial vaginosis, their pattern, clinical features, and laboratory parameters in pregnant women with human papillomavirus (HPV) infection. Material and methods. A total of 682pregnant women infected with HPV were examined. A PCR assay for HPV (Quantum-21), pH-metry, microscopy of vaginal smears, real-time PCR (Femoflor-16), and cervical cytological examination were used. Results. Among the 682 pregnant women infected with HPV, 38.7% had vaginal dysbiosis, of whom 48.1% had a recurrent course. The pattern of recurrent vaginal dysbiosis was marked by bacterial vaginosis (BV) in 34.7% of the patients; BV was concurrent with aerobic vaginitis and Candida vulvovaginitis in 44.1 and 18.1 %, respectively; the concurrence of all the above infections was seen in 3.2%. The total rate of coinfections was 65.4%. Dysbiosis was clinically asymptomatic in 34.6% of the pregnant women. The mean pH values were 4.53±1.62 (95% CI, 4.04-5.02). In the presence of aerobic microorganisms, basal and parabasal cells were absent in the vaginal discharge at smear microscopy. Cervical intraepithelial changes occurred in every four patients; moreover, there were atypical squamous cells of undetermined significance (ASCUS) (12.6%), low-grade squamous intraepithelial lesions (LSIL) (11.8%), High-grade squamous intraepithelial lesions (HSIL) (0.8%). Conclusion. Pregnant women infected with HPV have a high incidence of vaginal dysbiosis of mixed etiology and its recurrences, as well as low-risk cervical intraepithelial lesions.

pregnancy, human papillomavirus, dysbiosis, bacterial vaginosis, vulvovaginal candidiasis, aerobic vaginitis, coinfection, lactobacilli