Association between human papillomavirus and chlamydia trachomatis infection risk in women: a systematic review and meta-analysis

Int J Public Health. 2019 Jul;64(6):943-955. doi: 10.1007/s00038-019-01261-w. Epub 2019 Jun 8.

Abstract

Objectives: Human papillomavirus (HPV) and chlamydia trachomatis (Ct) infection lead to severe consequences for women's health. This meta-analysis summarizes the evidence on HPV infection risk in women with chlamydia and chlamydia risk in HPV-positive women.

Methods: Medline, Web of Science and Scopus were systematically searched for eligible publications until May 2018. Eligibility criteria included: assessment of HPV/Ct infection; cohort, case-control, cross-sectional study design; and reported risk estimation with its 95% CI for HPV infection in Ct-positive women and/or Ct infection in HPV-positive women. On the PRISMA guidelines, meta-analysis was performed using random effect model.

Results: Forty-eight studies met the eligibility criteria. Among women with chlamydia, the odds ratio (OR) of HPV infection is 2.12 (95% CI 1.80, 2.49) and the OR of high-risk HPV infection is 2.32 (95% CI 2.02, 2.65). The OR for chlamydia among HPV-positive women is 2.23 (95% CI 1.70, 2.92).

Conclusions: HPV and Ct behave as reciprocal risk factors. In women diagnosed with HPV infection or chlamydia, the screening for the mutual infection could represent a preventive intervention for severe reproductive health outcomes, such as cervical cancer and infertility.

Keywords: Chlamydia trachomatis; Meta-analysis; Papillomavirus infections; Sexually transmitted diseases; Systematic review; Women’s health.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Case-Control Studies
  • Chlamydia Infections / epidemiology*
  • Chlamydia trachomatis / isolation & purification
  • Cohort Studies
  • Comorbidity*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / epidemiology*
  • Prevalence
  • Risk Factors
  • Sexually Transmitted Diseases / epidemiology*