Prevalence of Human Papillomavirus, Cytomegalovirus and Chlamydia trachomatis among Women with Normal Cervical Cytology and their Impact on TLRs Expression

Abstract

To study the prevalence of HPV infection and its associated co-infection among sexually active women with normal cytology and to correlate the infection status with TLR expression. In a population based study, first voided urine samples were collected from 370 sexually active women with normal cervical cytology. The presence of HPV, CMV and CT infections were by PCR based approach. The expression pattern of TLR2 and TLR4 was analyzed in formalin fixed cervical tissue samples by immunohistochemistry. An overall HPV, CMV and CT prevalence of 22.6, 6.8 and 2.3%, respectively was reported among the study population. Further it was observed that women with HPV infections were more prone to CMV (OR: 1.79, 95% CI 0.69-4.63) and CT (OR: 22.41, 95% CI 2.65-189.48) infections. The immunostaining of the formalin fixed blocks with anti-TLR2 and TLR4 showed surface expression of TLRs in cervical squamous with no infection and TLR2 and TLR4 immunoreactivity in infected cervical samples were markedly negative. The infection of the cervix with HPV, CMV and CT decreases TLR2 and TLR4 expression in cervical squamous and thus abolishes the innate immune responses. The abolished TLR response may be a crucial step in the carcinogenic events mediated by infectious agents.