Bacterial Vaginosis and Its Association With Incident Trichomonas vaginalis Infections: A Systematic Review and Meta-Analysis

Abstract

Background: Bacterial vaginosis (BV) has been associated with an increased risk for acquisition of human immunodeficiency virus and sexually transmitted infections. We evaluated the association between BV and incident Trichomonas vaginalis (TV) infection in women.Methods: MEDLINE and ClinicalTrials.gov were searched for articles published between January 1, 1980, and May 7, 2021. Observational studies in women that evaluated the relationship between having/not having BV and the risk for acquiring TV were included.Results: Fourteen studies were included in the systematic review; 12 studies were included in meta-analyses involving 18,424 participants. Most studies used Nugent scoring to diagnose BV. For TV diagnosis, 12 studies used wet mount microscopy or culture, and 2 used nucleic acid amplification tests. There was diversity in the measures of association used, so an overall effect size could not be calculated. The majority of studies reported odds ratios, which showed an increased risk of incident TV among women with BV versus without BV (adjusted odds ratio, 1.87; 95% confidence interval, 1.45-2.40; P = 0.007). However, there were heterogeneity and potential confounding factors (eg, age, sexual partners) reported among studies.Conclusions: This systematic review and meta-analysis provide evidence for a nearly 2-fold higher risk for acquiring TV among women with BV compared with women without BV.

Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study

“…This study hinted that history of other vaginitis and history of HPV infection were risk factors for UBV, consistent with another study which showed that women with BV were twice as likely to acquire trichomonal vaginitis compared with women without BV. [22] Specially, when it comes to history of other vaginitis, there existed a signi cant statistical difference (P1 = 0.0088). Reproductive history and menstrual cycle had little effect on UBV, but one study found luteal phase to be a protective factor of BV [17].…”

The microRNA Cargo of Human Vaginal Extracellular Vesicles Differentiates Parasitic and Pathobiont Infections from Colonization by Homeostatic Bacteria

“…Our study is also the first to investigate EV-miRNAs differential expression in response to axenic P. bivia vaginal colonization and to contrast that to L. crispatus colonization. P. bivia is an abundant pathobiont of the vaginal microbiome community state CST-IV, subtype A [ 67 ], which presents BV-related characteristics, and a close to 2-fold increased risk of acquiring T. vaginalis infection [ 18 ]. Both pathogens, T. vaginalis and P. bivia , uphold clinical relevance associated with poor perinatal outcomes, urogenital cancer, and increased susceptibility to viral STIs [ 6 ].…”

“…Sequencing of the cervical microbiome also ranked the L. crispatus -dominated CST as the least proinflammatory, and the P. bivia -dominated as the most proinflammatory, hence, pathogenic CST [ 13 ]. BV is linked with an increased risk of developing urogenital cancer, obstetric complications, and acquiring sexually transmitted infections (STIs) [ 6 ], including human papillomavirus (HPV) [ 14 , 15 ], human immunodeficiency virus (HIV) [ 16 , 17 ] and Trichomonas vaginalis ( T. vaginalis ) [ 18 ], the causative agent of trichomoniasis.…”

The role of the genital microbiota in the acquisition and pathogenesis of sexually transmitted infections

“…To our knowledge, Treponema pallidum has not been formally assessed in this context. By meta-analysis, microbiotas low in lactobacilli (by Nugent score, or sequencing, or inferred by Amsel criteria based BV diagnosis,) are associated with increased risk of HIV-1 [97,98,99], HPV [100 ▪▪ ,101] and C. trachomatis [100 ▪▪ ] by 1.5-fold and of T. vaginalis by almost 2-fold [102 ▪▪ ]. The evidence for N. gonorrhoeae and M. genitalium remains mixed [100 ▪▪ ].…”