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

ObjectivesHuman 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.MethodsMedline, 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.ResultsForty-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).ConclusionsHPV 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.