Molecular analysis and conventional cytology: association between HPV and bacterial vaginosis in the cervical abnormalities of a Brazilian population

Abstract

ABSTRACT. We investigated the association between bacterial vaginosis (BV) and human papillomavirus (HPV) infection in Papanicolaou smears in a Brazilian population. Cross-sectional analysis was performed on 673 samples collected from women attending public health centers in Olinda (PE, Brazil) by conventional (2015) cytology methodology and molecular analysis, PCR tests (GP5+/6+ and MY09/11). Cytological abnormalities, BV, and HPV-DNA were detected in 23 (3.4%) samples, 189 samples (28.1%), and 210 samples (31.2%), respectively. GP5+/6+ primers resulted in higher detection performance than MY09/11 primers, with 81% concordance between both primers (P < 0.0001). The occurrence of HPV-DNA and BV had ORs of 8.59 (P < 0.0001) and 2.91 (P = 0.0089) for abnormal cytology, respectively, whereas the concomitant presence of both infections showed an OR equal to 3.82 (P = 0.0054). Therefore, we observed an association between abnormal cervical cytology and HPV infection, BV, or both HPV infection and BV. These results highlight the necessity of monitoring patients presenting not only HPV, but also BV, as risk factors for cervical lesion development.

Profile of women with cervical cancer attended for treatment in oncology center

“…7 Several studies have demonstrated an association between bacterial vaginosis and HPV infection in the development of intraepithelial lesions, revealing association in almost 38% of cases. 8,9 Cytopathology is the choice method for the tracking of intraepithelial lesions precursors of cervical cancer, as well as contributing to recognition of infectious and/or inflammatory conditions. 10 In view of the beginning of an increasingly earlier and often unprotected sexual life, the favoring infection by HPV and other sexually transmitted microorganisms occurs, making clear the importance of using this test in tracking and prevention campaigns.…”

Inflammatory cells in liquid‐based cytology smears classified as bacterial vaginosis

“…Finally, cellular atypia was significantly associated with BV‐L (9.6% against 5.7%), although some reports did not find an association between cervical cytological abnormalities and BV others observed that both HPV infection and epithelial atypia were associated with BV . There has been no study about the association of atypia along with the presence of leukocytes (in cases with BV diagnosis, as shown here).…”

Liquid medium cytology performance in identification of cervico-vaginal microbiological agentes

“…(10,24) Apesar de a citopatologia ter sido criada originalmente para o rastreamento das lesões pré-malignas e malignas do colo do útero, a identificação morfológica e a evidência de sinais citopáticos de agentes infecciosos do colo do útero e vagina, por meio deste método, é de grande importância para o controle de doenças sexualmente transmissíveis, que causam grande impacto na saúde pública brasileira e, muitas vezes, podem atuar como cofatores das lesões intraepiteliais de alto grau e câncer invasor, influenciando a progressão da infecção cervical pelo HPV. (19,(25)(26)(27) CONCLUSÕES Observou-se uma boa concordância entre a citologia convencional e em meio líquido na identificação dos agentes Candida spp. e Gardnerella vaginalis/Mobiluncus spp., assim como uma boa concordância entre as duas metodologias frente ao exame microbiológico na evidência de Gardnerella vaginalis/Mobiluncus spp., sendo possível evidenciar que ambas as técnicas mostram-se efetivas na identificação de diversos agentes microbiológicos de interesse clínico, apesar do melhor desempenho da citologia convencional para a identificação de Trichomonas vaginalis.…”