Association of Bacterial Vaginosis and HR-HPV Infection with Uterine Cervical Intraepithelial Neoplasia among Saudi women in Al-Madinah Al-Munawarah

Bacterial vaginosis (BV) is an infection of vagina. Millions of women suffer from this prevalent infection. Obstetric and gynecological issues may cause from the infection. Cervical cancer may be related to BV. However, different studies have demonstrated that papillomavirus infections, particularly those related to the high-risk human papillomavirus (HR-HPV) group, are among the most important causes of malignant and premalignant lesions in women's uterine cervixes. There for this study aimed to detect the association of BV and the development of HR-HPV related cervical intraepithelial neoplasia (CIN) among Saudi women in Al-Madinah Al-Munawara. Two hundred and thirty-eight (n=238) samples were processed for cytological examination and PCR targeting HPV as well as BV (only 170). Precancerous epithelial lesions were found to be uncommon among Saudi women (13/238, 5.5%). On the other hand, the incidence of HR-HPV was detected in only six (2.5%) cases, two of them present in patients with epithelial change with prevalence of HPV in relation to epithelial change of 15.4% (2/13) both exhibiting genotype 16, Conversely, the remaining genotypes (HPV 52, 33 and HPV58) were found in patients free for premalignant and malignant cells. Concerning BV, 12.4% (21/170) of the study population were found to be suffering from investigated BV, distributed as follows: G.vaginalis and P. lacrimalis were detected in 4(2.3%) cases for every pathogen. While L. iners was demonstrated n 13(7.6%). Moreover, the two patients exhibiting both HPV 16 positive and abnormal cytological changes appeared to be free from bacterial vaginosis. The study concluded that there is no relation between bacterial vaginosis and the progression of HPV-related cervical cytological changes. Furthermore, low prevalence of HR-HPV among Saudi women with slight correlation with cervical intraepithelial neoplasia (CIN), This might guide the researchers to search for other suspected HPV genotypes rather than investigated types involved in the study. Keywords: Cervical cancer, high-risk human papilloma virus (HR-HPV), low-risk human papilloma virus (LR- HPV), Saudi women, Al-Madinah Al Munawarah, Saudi Arabia, bacterial vaginosis