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Eur J Clin Microbiol Infect Dis (2016) 35:657664 DOI 10.1007/s10096-016-2584-1
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Bacterial vaginosis, aerobic vaginitis, vaginal inflammation and major Pap smear abnormalities
P. Vieira-Baptista1 & J. Lima-Silva1 & C. Pinto1 & C. Saldanha2 & J. Beires1 &
J. Martinez-de-Oliveira3,4 & G. Donders5,6
Received: 5 October 2015 /Accepted: 13 January 2016 /Published online: 25 January 2016 # Springer-Verlag Berlin Heidelberg 2016
Abstract The purpose of this investigation was to evaluate the impact of the vaginal milieu on the presence of abnormal Pap smears and a positive human papilloma virus (HPV) test. A cross-sectional study was conducted between June 2014 and May 2015, evaluating the vaginal discharge by fresh wet mount microscopy and comparing these data with Pap smear findings. Wet mount slides were scored for bacterial vaginosis (BV), aerobic vaginitis (AV), presence of Candida and Trichomonas vaginalis. Cytologic evaluation was done on all Pap smears according to the Bethesda criteria. The cobas HPV Test (Roche) was performed for HPV detection. A total of 622 cases were evaluated. The mean age of the patients was 41.6 10.65 years (range 2175). Eighty-three women (13.3 %) had a cytology result worse than low-grade squamous intraepithelial lesion (LSIL). When comparing this group with the one with normal or minor [atypical squamous cells of undetermined significance (ASC-US) or LSIL] Pap smear abnormalities, there were no differences in the presence of Candida (32.5 % vs. 33.2 %, p = 1.0), absence of
lactobacilli (38.6 % vs. 32.5 %, p = 0.32) or BV (20.5 % vs.13.2 %, p = 0.09). On the other hand, moderate or severe inflammation (msI) (41.0 % vs. 28.8 %, p = 0,04), moderate or severe AV (msAV) (16.9 % vs. 7.2 %, p = 0.009) and msAV/ BV (37.3 % vs. 20.0 %, p = 0.001) were more common in women with such major cervical abnormalities. No significant association was found between deviations of the vaginal mi-lieu and high-risk HPV infection. The presence of msI or msAV, but not BV, is independently associated with an increased risk of major cervical cytological abnormalities, but not with HPV infection.
Introduction
Aerobic vaginitis (AV) was...