HPV coinfection with bacteria
HPV infections can also occur concurrently with bacterial infections. Coinfection refers to the presence of multiple infections, in this case, both HPV and bacteria, in the same individual. While the focus of HPV infection is primarily on viral interactions, the presence of bacteria can influence the clinical course and outcomes of HPV-related diseases.82-86
Chlamydia trachomatis is a bacterial pathogen that can cause sexually transmitted infections. Studies have reported an association between HPV infection and concurrent Chlamydia trachomatisinfection. Coinfection with Chlamydia trachomatis may enhance HPV persistence and increase the risk of HPV-related complications, such as cervical dysplasia and cervical cancer.82-85,87
Mycoplasma genitalium is another bacterial pathogen associated with sexually transmitted infections. Some studies have suggested an association between Mycoplasma genitalium infection and HPV infection, particularly in individuals with persistent HPV infections. Coinfection with Mycoplasma genitalium may influence the persistence and progression of HPV-related diseases.87,88
Group B Streptococcus (GBS) is a bacterium commonly associated with genital tract colonization and infections in women. Limited studies have suggested an association between GBS colonization and HPV infection. However, the clinical significance and impact of this coinfection on HPV-related diseases are not well established.87,89
Bacterial vaginosis (BV) is characterized by an imbalance of vaginal microbiota, with a decrease in Lactobacillus species and an increase in various bacteria. Some studies have shown an association between BV and HPV infection, particularly high-risk HPV types. BV may create an environment that favors HPV persistence and progression to cervical dysplasia.87,90,91
While less studied, other bacterial infections, such as Neisseria gonorrhoeae and Haemophilus ducreyi , have been reported in association with HPV infection. These coinfections may impact the clinical course, progression, and treatment outcomes of HPV-related diseases.87,92