The association between oxidative balance score and human papillomavirus infection in women: A cross-sectional study from NHANES

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Background Understanding the dietary and lifestyle factors associated with human papillomavirus (HPV) infection is of public health significance. The combined effects of an antioxidant diet and lifestyle on HPV infection remain unclear. We aim to investigate the association between oxidative balance score (OBS) and HPV infection in women. Methods We conducted a cross-sectional study involving 8 204 female participants from the National Health and Nutrition Examination Survey (NHANES) 2003–2016. Sixteen dietary and four lifestyle components were used to calculate the OBS. Multivariable logistic regression was used to analyze the association between OBS and HPV infection. Restricted cubic splines were used to examine the dose-response relationship. Results Among the included participants, 3 620 (44.1%) had an HPV infection. The risk of HPV infection decreased with higher OBS, from 52.6% in the lowest quintile of OBS (Q1) to 37.0% in the highest quintile of OBS (Q5). After multivariable adjustment, the ORs (95% CIs) for Q2-Q5 of OBS were 0.93 (0.74-1.17), 0.81 (0.64-1.01), 0.73 (0.59-0.90), and 0.70 (0.57-0.85), respectively, compared with the Q1 group. OBS was also negatively associated with the risk of multiple HPV infections. There was a linear dose-response relationship between OBS and HPV infection ( P for nonlinearity=0.855). Conclusions An antioxidative lifestyle is associated with a lower prevalence of genital HPV infection in women. Future prospective studies are needed to validate the effect of OBS on the risk of incident and persistent infection with HPV.