Association of Trichomonas vaginalis and Cytological Abnormalities of the Cervix in Low Risk Women

Abstract

ObjectiveIs Trichomonas vaginalis (TV) an inducing factor for the development of (pre-)cancerous lesions of the cervix?DesignCross sectional study.SettingScreening healthy Belgian women with low infection risk.Sample63,251 consecutive liquid based cervical samples.MethodsReal time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities. Main Outcome MeasuresAssociation of TV and HPV with cervix dysplasiaResultsThe overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6). In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05), mainly due to an increase in ASC-US and LSIL, but not HSIL. ConclusionsWe conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.

Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000–2012

“…Lazenby et al [27] discovered more than sixfold higher risk of women with TV being infected with HPV type 16 infection. We saw an association of TV with ASCUS and LSIL which was similar to the findings of a Belgian study where such associations were seen among women with high-risk HPV infection [28]. Depuydt et al [29] in their study done in Antwerp also demonstrated a higher association between TV and HPV infections.…”

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing

“…Interestingly, the finding of TV showed statistical significance for the ASC-H group. Another study found an association between ASC-US and these vaginal protozoa when comparing LBC results (SurePath ® ) and using real-time PCR for TV, but no cases of ASC-H were reported with this pathogen [11] . This discrepancy in the results can be explained by the more sensitive method used in that study, as well as the different populations examined.…”

“…Cervicovaginal infections are common in women and cause uncomfortable symptoms, such as vaginal discharge, odor, and pruritus [9,10] . Concomitant infections by multiple microorganisms are also common, and they may have symbiotic interactions [11] . Some of these pathogens can infect the female genital mucosa and induce cytological atypia [12] .…”

Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice

“…To date, tests like the APTIMA or BD affirm VPIII T. vaginalis assays have proven to be sensitive and specific [41][42][43][44][45], but they are not yet widely available, applied and cost-effective for many settings. Still, T. vaginalis is a silent danger, that is, in many settings, more prevalent and endemic than previously understood, it has been associated with pelvic in-flammatory disease and adverse outcomes of pregnancy (low birth weight and premature birth), and that can also disturb the cytological diagnosis of cervix smears [46]. Moreover, T. vaginalis increases the risk to acquire and transmit several other STIs including HIV [47][48][49], and it may spread to sexual partners because they are not aware of its presence.…”