VARIABILITY OF POLYMERASE CHAIN REACTION-BASED DETECTION OF HUMAN PAPILLOMAVIRUS DNA IS ASSOCIATED WITH THE COMPOSITION OF VAGINAL MICROBIAL-FLORA

The results of repeated human papillomavirus (HPV) DNA testing were co mpared to changes in cervical pathology and the composition of vaginal microorganisms. A cohort of 19 women with HPV cervical infections in the absence of cervical intraepithelial neoplasia at enrollment was re ex amined on average at 7.3-month intervals over a 2-year period. At e ach follow-up visit, cytological and colposcopic examinations were don e and vaginal microorganisms were assessed quantitatively by Gram stai ning of secretions, and anaerobic and aerobic culture. HPV genotypes 6 , 11, 16, and 18 were detected by polymerase chain reaction analysis u sing DNA isolated from exfoliated cervical cells. The detection of HPV DNA was significantly associated with carriage of Grade II flora (P < 0.001), isolation of Gardner ella vaginalis (P = 0.03), Ureaplasma ur ealyti cum (P = 0.04), Candida albicans (P = 0.01), Bacteroides specie s (P = 0.01), and overgrowth by anaerobes (P = 0.004). Normal vaginal flora, characterised by the predominance of Lactobacillus species, was significantly associated (P < 0.001) with a negative HPV test. The de tection of HPV DNA is associated with the composition of microorganism s present in the vagina at the time of testing. (C) 1994 Wiley-Liss, I nc.