Title: The prevalence of human papillomavirus and bacterial vaginosis among young women
in China: a cross-sectional study
Version: 1 Date: 30 Mar 2021
Reviewer's report:
The present study entitled “The prevalence of human papillomavirus and bacterial vaginosis
among young women in China: a cross-sectional study” aimed to assess the epidemiology of
HPV combined with BV prevalence among 2000 sexually active Chinese women aged 20-35
years. Overall, the manuscript is well written and presents interesting data, however, but it still
needs some points to be addressed.
Abstract:
Please consider to change “…genital tract health” to other expression (formal/ technical).
Please consider the following terms that should not be firstly written as abbreviation. For
example: HPV- first written human papillomavirus (HPV); HR-HPV, High-risk HPV?; CIN;
NILM; among others. Please revise this issue in all manuscript.
The conclusion of the abstract was driven taking into account the results and a possible
adjustment of HPV vaccination. What do you mean with flexible HPV vaccination project? The
driven conclusion not is not properly the answer of the main objective (“The objective of this
study was to assess the epidemiology of HPV combined with BV prevalence among Chinese
women aged 20-35 years”). As so, the driven conclusion is not reflected in the title of the paper
as well.
Materials and methods:
Study design and participants: The authors refer that women were volunteer; however, it is
important to clarify if there was money or other type of compensation involved.
How was the “no history of cervical treatment or surgery” assessed? Self-report or clinical report
based?
Results:
The presentation of HPV (overall and by genotypes) prevalence, BV, among others, should be
correct to one decimal place.
For example, after a quick search for other BMC Women's Health papers, “2,000 women” should
be presented as following: “2000 women”; “The LR-HPV positivity rate was 3.30% (62/1,878)”
should be replaced by “The LR-HPV positivity rate was 3.30% (62/1878)”. Please revise all the
similar results.
Please standardize the presentation of the Odds ratio and confidence intervals. BV was related
with different HPV genotype prevalence risk. “HPV prevalence risk assessment
165 was as follows: HPV-51 (odds ratio [OR]: 5.351; 95% CI: 2.051-13.956) and HPV-52
166 (OR: 2.592; 95% CI: 1.105-6.076) (Table 1)”. The OR and 95% CI included in Table 1 are
presented with 2 decimal places. Please revise.
Discussion:
Line 262-274:
Please consider that BV is characterized by dysbiotic cervicovaginal microbiota. It is important
to present the difference between a healthy/ normal microbiota and a dysbiotic one. In BV, there
is a crosstalk between host physiological, immunological and metabolic homeostasis, which
ultimately, can impact the HPV infection and cervical cancer precursor lesions. Please revise,
taking into account the studied population.
Line 275-279:
“The relationships between other sexually transmitted infections and HPV remain unknown.”
Is this a limitation of your study? Several papers have characterized the relationships between
genital HPV infection and other genital pathogens, such as Chlamydia trachomatis, Neisseria
gonorrhoeae, Trichomonas vaginalis, among others. Please revise.
Please complete the list of abbreviations.
Several abbreviated HPV-related conditions were not listed. Please revise.
Please add the following to the abbreviations’ list:
HR-HPV
LR-HPV
CIN- Cervical intraepithelial neoplasia
NILM- negative for intraepithelial lesion or malignancy?
ASC-US
As the authors used in the main text, in Figure 2 “type” should be changed for “genotype”.