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Bacterial vaginosis and specific high-risk human papillomavirus genotype infection: a cross-sectional study in

Raymond Chibvongodze¹, Mutinda Cleophas Kyama², Lucy Muchiri¹

¹Department of Human Pathology, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya.

Frontiers in Global Women'S Health

|July 3, 2026

Abstract

Background:

Emerging evidence indicates that bacterial vaginosis (BV) plays a role in high-risk Human Papillomavirus (hr-HPV) infection. However, the BV/hr-HPV association is still an under-explored concept in Africa, a region overburdened by the highest prevalence of both infections and cervical cancer in the world. Additionally, there is a significant knowledge gap regarding which specific hr-HPV genotypes contribute to this association in Africa. The objective of this study was to investigate whether BV is significantly associated with hr-HPV infection in Africa, with particular emphasis on the specific hr-HPV genotypes contributing to this association.

Methods:

This publication is based on a cross-sectional analysis of baseline data from an ongoing cohort study. A total of 498 women met the eligibility criteria and were screened for BV, hr-HPV, and cervical lesions at baseline between July 2022 and November 2023. Logistic regression, Chi-square tests, and t tests were used to investigate associations among hr-HPV genotypes, BV, cytology results, and other risk factors. In all tests, a p-value of <0.05 was considered to indicate statistical significance.

Results:

The BV infection and hr-HPV infection rates were 24.7% (123/498) and 28.1% (140/498), respectively. Almost one-tenth (49/498) of the enrolled women had BV/hr-HPV coinfection. A significant association between BV and pooled hr-HPV status (inclusive of the HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, and -68 genotypes) was confirmed in this study (aOR = 2.38, 95% CI: 1.48-3.81), p < 0.001). BV was significantly associated with HPV-39 and HPV-52 genotypes (aOR: 3.23, 95% CI: 1.37-7.64, p = 0.007) and (aOR: 5.38, 95% CI: 1.17-24.74; p = 0.03), respectively. HPV-16 and HPV-68 were significantly associated with abnormal Pap smears (p = 0.046 and p = 0.001, respectively).

Conclusions:

BV was found to be significantly associated with pooled hr-HPV status, HPV-39, and HPV-52 infection in Kenyan women. These findings underscore the importance of treating BV promptly, as doing so may help minimize hr-HPV infection.

Keywords:

Africa bacterial vaginosis cervical cancer epidemiology human papillomavirus odds ratio pap smear polymerase chain reaction

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