Gynecological symptoms and vaginal wet smear findings in women with cervical human papillomavirus infection

OBJECTIVES: To investigate the signs, symptoms and changes in the vaginal milieu that could be associated with cervical human papillomavirus infection (CHPI). STUDY DESIGN: Women (n = 972) attending for contraceptive advice were tested for human papillomavirus in cervical samples. Results of gynecological history, examination, and vaginal wet smear findings were compared between CHPI patients and negative women. RESULTS: Sixty-six (6.8%) of the women had a CHPI. Bacterial vaginosis was more common among those with, than without, CHPI, but the significance of this association was abolished after adjustment for age and for markers of sexual risk-taking. Vaginal discharge with a fishy odor, a positive amine test, and genital fissures showed significant correlations with CHPI, which persisted after adjustments. Symptoms of proctitis also correlated with CHPI, and remained significant after adjustment for anal sex. CONCLUSION: Bacterial vaginosis is associated with the presence of CHPI, possibly due to sexual behavioral factors. However, several other features, in particular the presence of amines, may be independently associated with CHPI.