Association between genital mycoplasmas infection and human papillomavirus infection, abnormal cervical cytopathology, and cervical cancer: a systematic review and meta-analysis

Arch Gynecol Obstet. 2018 Jun;297(6):1377-1387. doi: 10.1007/s00404-018-4733-5. Epub 2018 Mar 8.

Abstract

Background: Some studies demonstrated that female genital mycoplasmas play important roles in human papillomavirus (HPV) infection, abnormal cervical cytopathology, and cervical cancer. However, those results remained inconclusive. We aimed to perform a systematic review and meta-analysis to investigate the association between female genital mycoplasmas and those disorders.

Methods: Computerized databases were comprehensively searched before 26 January 2017. Pooled odd radios (ORs) and correlative 95% confidence intervals (CIs) were adopted to evaluate the strength of association.

Results: Our meta-analysis included 22 studies with 16,181 participants. Ureaplasma urealyticum and Ureaplasma parvum were associated with a significantly increased risk of overall HPV infection (OR 1.57, 95% CI 1.05-2.34; OR 3.02, 95% CI 2.10-4.33, respectively), and U. urealyticum and Mycoplasma genitalium were associated with a significantly increased risk of high-risk HPV infection (OR 1.37, 95% CI 1.05-1.80; OR 1.50, 95% CI 1.11-2.02, respectively). In addition, U. urealyticum, U. parvum, and Mycoplasma hominis were associated with a significantly increased risk of abnormal cervical cytopathology (OR 1.51, 95% CI 1.23-1.85; OR 1.41, 95% CI 1.10-1.80; OR 1.48, 95% CI 1.10-1.99, respectively).

Conclusion: We found that U. urealyticum and M. genitalium may increase the risk of high-risk HPV infection, while U. urealyticum, U. parvum, and M. hominis may increase the risk of abnormal cervical cytopathology.

Keywords: Abnormal cervical cytopathology; Cervical cancer; Human papillomavirus; Mycoplasma; Ureaplasma.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Cervix Uteri / microbiology*
  • Cervix Uteri / virology*
  • Female
  • Humans
  • Mycoplasma / isolation & purification*
  • Mycoplasma Infections / diagnosis*
  • Mycoplasma Infections / microbiology
  • Mycoplasma genitalium / isolation & purification
  • Mycoplasma hominis / isolation & purification
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / virology
  • Risk Factors
  • Ureaplasma / isolation & purification
  • Ureaplasma Infections / diagnosis*
  • Ureaplasma Infections / microbiology
  • Ureaplasma urealyticum / isolation & purification
  • Uterine Cervical Neoplasms / microbiology
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / virology