Clinical significance of human papillomavirus co-infection with sexually transmitted infections in the development of precancerous conditions of the cervix in women of reproductive age

Introduction: Human papillomavirus (HPV) is the main cause of cervical cancer. Cervical-vaginal infection with pathogens such as bacterial vaginosis, mycoplasmosis, and vaginal candidiasis may be a cofactor. This study aimed to assess the impact of co-infection with human papillomavirus and sexually transmitted infections on the development of cervical precancerous conditions in reproductive-age women. Materials and Methods: In the study, 402 women had smears taken for cytological examination and cervical scrapings taken for sexually transmitted infections (STIs). The samples were analyzed by polymerase chain reaction. Results: In the study, the incidence of STIs was 77.8%, with rates being two times lower in the HPV-positive group (33.9% versus 66.1% among HPV-negative women, p = 0.4). Notably, all women with mild and severe dysplasia had a combination of HPV and STIs. A typical combination was HPV 16, 58, and 33, often accompanied by Gardnerella vaginalis, cytomegalovirus, or Candida albicans. Conclusion: Women positive for HPV and STIs had abnormal Pap smears. Women with cervical precancerous lesions and vaginal infection were less likely to have HPV, except in high-grade squamous intraepithelial lesions. Women with high grade squamous intraepithelial lesions HPV were combined with Gardnerella, mycoplasmosis, and candidiasis.