{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:28:29Z","timestamp":1781591309417,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>We conducted a prospective study with the aim of determining HPV prevalence and type distribution in the general female population of Southern Croatia (SDC), and to detect the presence of other microorganisms in the lower part of the female reproductive system and their possible influence on the frequency of HPV infection. Data were collected during routine check-up exams. All participants were examined by a gynecologist, and cervico-vaginal scrapings\/swabs were collected, for cytological (Pap smear) and microbiological (for bacterial growth, genital mycoplasmas, chlamydia, and HPV) analysis. Informed consent was obtained from all participants with accompanying questionnaire. A total of 1050 asymptomatic women living in SDC participated in the study during a one-year period, and 107 of them (10.2%) had HR-HPV infection. We found that the presence of some bacteria (Ureaplasma, Chlamydia, and Gardnerella) in the lower part of the female genital system has a positive correlation with the frequency of HPV infection and, consequently, a possible influence on faster progression to cervical dysplasia caused by HPV. We consider that inclusion of screening for sexually transmitted infections as monitoring in women with HPV infection could help to find women at risk of cervical cancer progression.<\/jats:p>","DOI":"10.3390\/v15020443","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T04:08:07Z","timestamp":1675656487000},"page":"443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of Human Papillomavirus (HPV) among Females in the General Population of the Split and Dalmatia County and Its Association with Genital Microbiota and Infections: A Prospective Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3378-4791","authenticated-orcid":false,"given":"Vanja","family":"Kaliterna","sequence":"first","affiliation":[{"name":"Teaching Institute for Public Health of Split and Dalmatia County, 21000 Split, Croatia"},{"name":"University Department of Health Studies, University of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Kaliterna","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidija","family":"Pejkovic","sequence":"additional","affiliation":[{"name":"Gynecological Practice, 21210 Solin, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Vulic","sequence":"additional","affiliation":[{"name":"Gynecological Practice, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Zanchi","sequence":"additional","affiliation":[{"name":"Gynecological Practice, 21212 Kastel Sucurac, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karmen","family":"Cerskov","sequence":"additional","affiliation":[{"name":"Gynecological Practice, 21212 Kastel Sucurac, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"Bruni, L., Albero, G., Serrano, B., Mena, M., Collado, J.J., G\u00f3mez, D., Mu\u00f1oz, J., Bosch, F.X., and de Sanjos\u00e9, S. (2023, January 09). Human Papillomavirus and Related Diseases in Europe; Summary Report 22 October 2021. ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre). Available online: https:\/\/hpvcentre.net\/statistics\/reports\/XEX.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.2741\/4662","article-title":"Genital human papillomavirus infections","volume":"23","author":"Kaliterna","year":"2018","journal-title":"Front. Biosci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F","article-title":"Human Papillomavirus is a necessary cause of invasive cervical cancer worldwide","volume":"189","author":"Walboomers","year":"1999","journal-title":"J. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4478","DOI":"10.1002\/jmv.27837","article-title":"Microbiota and HPV: The role of viral infection on vaginal microbiota","volume":"94","author":"Santella","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_6","unstructured":"Croatian Institute of Public Health, Croatian National Cancer Registry (2022). Cancer Incidence in Croatia 2020, Croatian National Cancer Registry. Bulletin No. 45."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e203202","DOI":"10.5327\/DST-2177-8264-20203202","article-title":"What influence does vaginal microbiota have on Human Papillomavirus infection?","volume":"32","author":"Junior","year":"2020","journal-title":"J. Bras. Doen\u00e7as Sex. Transm."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"26","DOI":"10.21101\/cejph.a3814","article-title":"Prevalence and genotyping of the Human papillomavirus in the cervical specimens among women of Southern Croatia (Dalmatia county)","volume":"21","author":"Kaliterna","year":"2013","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sabol, I., Milutin Ga\u0161perov, N., Matovina, M., Bo\u017einovi\u0107, K., Grubi\u0161i\u0107, G., Fistoni\u0107, I., Belci, D., Alemany, L., D\u017eebro, S., and Dominis, M. (2017). Cervical HPV type-specific pre-vaccination prevalence and age distribution in Croatia. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0180480"},{"key":"ref_10","unstructured":"Kaliterna, V., Pejkovic, L., Vulic, R., Zanchi, L., and Cerskov, K. (2019). Accelerating Detection and Elimination of HPV and Related Cancers, Proceedings of the EUROGIN (European Research Organization on Genital Infection and Neoplasia) 2019, Larvotto, Monaco, 4\u20137 December 2019, EUROGIN."},{"key":"ref_11","unstructured":"Kaliterna, P. (2020). Human Papillomavirus (HPV) Prevalence and Genotypes Distribution in the General Female Population of Split and Dalmatia County. [Master\u2019s Thesis, School of Medicine, University of Split]. Available online: https:\/\/urn.nsk.hr\/urn:nbn:hr:171:921129."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1001\/jama.287.16.2114","article-title":"The 2001 Bethesda System: Terminology for reporting results of cervical cytology","volume":"287","author":"Solomon","year":"2002","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S1473-3099(07)70158-5","article-title":"Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: A meta analysis","volume":"7","author":"Diaz","year":"2007","journal-title":"Lancet Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ijid.2018.06.001","article-title":"The association between sexually transmitted infections, human papillomavirus, and cervical cytology abnormalities among women in Greece","volume":"73","author":"Parthenis","year":"2018","journal-title":"Int. J. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9678104","DOI":"10.1155\/2019\/9678104","article-title":"Correlation between Common Lower Genital Tract Microbes and High-Risk Human Papillomavirus Infection","volume":"2019","author":"Lv","year":"2019","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"980","DOI":"10.52142\/omujecm.39.4.11","article-title":"Does the frequency of ureaplasma increase in human papillomavirus positive women?","volume":"39","author":"Madenli","year":"2022","journal-title":"J. Exp. Clin. Med."},{"key":"ref_17","first-page":"e21331","article-title":"The Role of Chlamydia Trachomatis in the Pathogenesis of Cervical Cancer","volume":"14","author":"Iskander","year":"2022","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"915","DOI":"10.7150\/ijms.26523","article-title":"Co-infection Of Ureaplasma urealyticum And Human Papilloma Virus In Asymptomatic Sexually Active Individuals","volume":"15","author":"Kim","year":"2018","journal-title":"Int. J. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Usyk, M., Zolnik, C.P., Castle, P.E., Porras, C., Herrero, R., Gradissimo, A., Gonzalez, P., Safaeian, M., Schiffman, M., and Burk, R.D. (2020). Cervicovaginal microbiome and natural history of HPV in a longitudinal study. PLoS Pathog., 16.","DOI":"10.1371\/journal.ppat.1008376"},{"key":"ref_20","unstructured":"Usyk, M., Zolnik, C.P., Castle, P.E., Porras, C., Herrero, R., Gradissimo, A., Gonzalez, P., Safaeian, M., Schiffman, M., and Burk, R.D. (2022). and Costa Rica HPV Vaccine Trial (CVT) Group. Association between Cervical Microbiota and HPV: Could This Be the Key to Complete Cervical Cancer Eradication?. Biology, 11."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.cmi.2018.04.019","article-title":"The vaginal microbiota and its association with Human Papillomavirus, Chlamydia trachomatis, Neisseria gonorrhea and Mycoplasma genitalium infections: A systematic review and meta-analysis","volume":"25","author":"Tamarelle","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.21037\/atm-20-5832","article-title":"Association of high-risk human papillomavirus infection duration and cervical lesions with vaginal microbiota composition","volume":"8","author":"Liu","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"986","DOI":"10.18203\/2320-1770.ijrcog20220595","article-title":"A critical review of the vaginal microbiota and its relationship with human papillomavirus","volume":"11","author":"Abdallah","year":"2022","journal-title":"Int. J. Reprod. Contracept. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Gillet, E., Meys, J.F., Verstraelen, H., Verhelst, R., De Sutter, P., Temmerman, M., and Broeck, D.V. (2012). Association between bacterial vaginosis and cervical intraepithelial neoplasia: Systematic review and meta-analysis. 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