Association Of Gardnerella Vaginalis Virulence Genes With Human Papilomavirus Infection In Women With Bacterial Vaginosis

Abstract

Introduction: Gardnerella vaginalis, is a major pathogen of  bacterial vaginosis in reproductive age women, produces virulence factors like vaginolysin and sialidase enzyme which change the vaginal mucosal barrier, increasing the probability of STI Infection. The aim of this study was to identify the association between Gardnerella vaginalis virulence factors and HR-HPV infection. Methods: A total of 224 vaginal and cervical specimens were collected from symptomatic women. Amsel’s criteria was used for the diagnosis of bacterial vaginosis, G. vaginalis, Vly, NanH1, and NanH3 genes were detected by polymerase chain reaction (PCR) while HR-HPV infection and viral load were detected by real time PCR. Results: Out of 224 vaginal specimens, bacterial vaginosis was diagnosed in (25%). G. vaginalis was detected in (81.48%) of the BV positive samples. Vly, NanH1, and NanH3 genes were identified in (76.19%), (95.23%), and (59.09%) of the isolates, respectively. HR-HPV was observed in (25%) of G. vaginalis positive samples. Genotype 51 was the most prevalent (25%) followed by Genotype 56 (23.21%), genotypes 31, 45, and 59 had the same prevalence rate (1.78%). A statistically significant association was observed between bacterial vaginosis and age (P≤0.05), with the highest prevalence in women aged 21-30yr, also between HPV infection and age (P≤0.01), with highest prevalence observed in women aged 31-40yr. A significant association (P≤0.05) was found between the presence of Vly, NanH1, and NanH3 and HR-HPV infection. Conclusion: Our results suggested that G. vaginalis virulence genes were significantly associated with HR-HPV infection, and may act as co-factors in the development of infection.