Co-infection of sexually transmitted pathogens and Human Papillomavirus in cervical samples of women of Brazil

Abstract

BackgroundSome sexually transmitted infectious agents, such as Chlamydia trachomatis and Herpes simplex, cause local inflammation, and could contribute to Human Papillomavirus (HPV) and cervical lesion progression. Thus, the aim of this study was to determine any association between the presence of microorganisms of gynecological importance, sexual behavior, clinical and demographical variables to the development and progress of cervical lesions.MethodsOne hundred and thirty-two women between 14 and 78 years and living at Vitória da Conquista, Bahia, Brazil, were included (62 individuals with cervical lesions and 70 without lesions). They answered a questionnaire to provide data for a socioeconomic and sexual activity profile. Samples of cervical swabs were collected and analyzed by PCR to detect genital microorganisms and HPV. Quantitative PCR was used to detect and quantify Ureaplasma urealyticum and Ureaplasma parvum. Univariate and multiple logistic regression were performed to measure the association with the cervical lesions, and an odds ratio (OR) with 95% confidence intervals (95%CI) were calculated. The Mann-Whitney U test was also used to compare the microorganism load in the case and control groups. The significance level was 5% in all hypotheses tested.ResultsCervical lesions were associated with: women in a stable sexual relationship (OR = 14.21, 95%CI = 3.67–55.018), positive PCR for HPV (OR = 16.81, 95%CI = 4.19–67.42), Trichomonas vaginalis (OR = 8.566, 95%CI = 2.04–35.94) and Gardnerella vaginalis (OR = 6.13, 95%CI = 1.53–24.61), adjusted by age and qPCR for U. parvum. U. parvum load showed a statistical difference between the case and control groups (p-value = 0.002).ConclusionVariables such as stable relationship, HPV, T. vaginalis, G. vaginalis were associated with cervical lesions in epidemiological studies. U. parvum load was higher in woman with cervical lesions compared with women without lesions. Additional studies are needed to better understand the role of these factors in cervical lesion development.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2835-5) contains supplementary material, which is available to authorized users.

Association of human papillomavirus and bacterial vaginosis with increased risk of high-grade squamous intraepithelial cervical lesions

“…These data are consistent with previous studies,27 in which G. vaginalis was detected in 91.9% of women with cervical lesions in addition to a positive association with the presence of injury, indicating a higher detection in women with high-grade squamous intraepithelial lesions. In another study, a positive association was found between the presence of G. vaginalis and cervical injury 28.…”

Evaluation of the Associations Between Cervical Microbiota and HPV Infection, Clearance, and Persistence in Cytologically Normal Women

“…Among them, the Ureaplasma parvum and their related taxa manifested higher richness in the baseline HPV-positive group compared with the baseline HPVnegative group. This is consistent with previous studies in different populations of the world indicating that Ureaplasma parvum was associated with a significantly increased risk of overall HPV infection and increased risk of abnormal cervical cytopathology (20)(21)(22). It was reported that the infection of Ureaplasma could lead to scarring and damage of the epithelium (23), suggesting that infection of the reproductive tract with Ureaplasma parvum might also increase the risk of HPV infection by facilitating viral infections.…”

Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy

“…However, several recent studies investigating the role of cervical co-infections of Ureaplasma spp. and other STIs in association with hrHPV, have supposed that these could be possible cofactors interacting with HPV in the development of precancerous and cancerous cervical lesions [31][32][33][34][35][36].…”

“…To date, nearly 200 different HPV types have been identified, including twelve classified by the International Agency for Research on Cancer (IARC) as oncogenic or "high-risk" HPV types (hrHPV 16,18,31,33,35,39,45,51,52, 56, 58 and 59) [2]. Although most HPV infections are benign, persistent infection with one of the carcinogenic hrHPV types is a well-established necessary cause of cervical cancer [3].…”