人乳头瘤病毒（HPV）感染，尤其是持续高危型HPV感染，与宫颈癌有关。女性生殖道微生态失调和下生殖道感染越来越与HPV感染和宫颈病变相关。由于它们共同的风险因素和传播途径，与其他性传播感染（STIs）的混合感染成为一种关注点。此外，支原体亚型的临床意义似乎有所不同。本研究旨在评估常见STIs和HPV感染之间的相关性，并调查Mycoplasma亚型的临床意义。我们招募了1,175名在北京大学第一医院妇科门诊进行宫颈癌筛查的患者，进行阴道炎和宫颈炎测试。他们都接受了HPV基因分型和STIs检测，其中749人接受了阴道镜检和宫颈活检。HPV阳性组中明显更常见的是需氧性阴道炎/脱屑性炎和STIs（主要是单一STIs）而非HPV阴性组。在单一STI患者中，与HPV阳性组相比，单纯疱疹病毒2型或UP6的感染率显著更高（ORadj: 1.810，95%CI：1.211-2.705，P=0.004；ORadj: 11.032，95%CI: 1.465-83.056，P=0.020，分别）。通过详细的Mycoplasma分类，发现不同的Mycoplasma亚型与HPV感染之间存在相关性。这些发现表明，在HPV阳性的人中应更加关注检测阴道微生态失调。此外，包括阴道感染和宫颈STIs在内的下生殖道感染在HPV阳性妇女中显著更常见，因此需要进行更彻底的检查。详细分类和有针对性的Mycoplasma治疗应成为临床实践中更加常见的做法。版权所有 © 2023 A、Bi、Zhang和Xiao。

Human papillomavirus (HPV) infection, especially persistent high-risk HPV, is associated with cervical cancer. Female reproductive tract microecological disorders and lower genital tract infections have been increasingly correlated with HPV infection and cervical lesions. Due to their common risk factors and transmission routes, coinfection with other sexually transmitted infections (STIs) has become a concern. Additionally, the clinical significance of Mycoplasma subtypes appear to vary. This study aimed to assess the correlations between common STIs and HPV infection, and to investigate the clinical significance of Mycoplasma subtypes.We recruited 1,175 patients undergoing cervical cancer screening at the Peking University First Hospital gynecological clinic from March 2021 to February 2022 for vaginitis and cervicitis tests. They all received HPV genotyping and detection of STIs, and 749 of them underwent colposcopy and cervical biopsy.Aerobic vaginitis/desquamative inflammatory vaginitis and STIs (mainly single STIs) were found significantly more often in the HPV-positive group than in the HPV-negative group. Among patients with a single STI, rates of infection with herpes simplex virus type 2 or UP6 in the HPV-positive group were significantly higher than in the HPV-negative group (ORadj: 1.810, 95%CI: 1.211-2.705, P=0.004; ORadj: 11.032, 95%CI: 1.465-83.056, P=0.020, respectively).Through detailed Mycoplasma typing, a correlation was found between different Mycoplasma subtypes and HPV infection. These findings suggest that greater attention should be paid to detecting vaginal microecological disorders in those who are HPV-positive. Further, lower genital tract infections, including both vaginal infections and cervical STIs, are significantly more common among women who are HPV-positive and who thus require more thorough testing. Detailed typing and targeted treatment of Mycoplasma should become more routine in clinical practice.Copyright © 2023 A, Bi, Zhang and Xiao.