The diagnosis ofTrichomonas vaginalis in liquid-based Pap tests: Correlation with PCR

Aslan, Deniz; Gulbahce, H. Evin; Stelow, Edward B.; Setty, Suman; Brown, Charlotte A.; McGlennen, Ronald C.; Pambuccian, Stefan E.

doi:10.1002/dc.20256

Cited by 26 publications

(17 citation statements)

References 28 publications

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“…However, with the majority of TV infections being asymptomatic, and the accuracy of cytology in its detection being extremely poor and generally below 60% [27-29], the odds are high that presence of TV would continue to interfere with correct identification of low grade cellular atypia, especially ASC-US. Even taking into consideration an apparently better sensitivity for TV detection when liquid based media are used [30,31], it would be unlikely that cytology will enable TV detection in a sufficiently accurate way to prevent false positive readings, certainly not in high prevalence areas. Therefore we strongly suggest that real time PCR should be used to detect TV in the same sample used for cytology and HPV DNA detection.…”

Section: Discussionmentioning

confidence: 99%

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

Donders

Depuydt²,

Bogers³

et al. 2013

PLoS ONE

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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.

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Section: Discussionmentioning

confidence: 99%

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

Donders

Depuydt²,

Bogers³

et al. 2013

PLoS ONE

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“…However, recently developed liquid-based Pap tests appear to be more accurate for microscopic identification of T vaginalis . Reported sensitivities range from 60% to 96% and specificities from 98% to 100%,15 16 suggesting that treatment of trichomoniasis identified in liquid-based Pap test pathology reports, without additional testing, may be justified.…”

Section: Laboratory Testing From Microscopy To Nucleic Acid Amplificamentioning

confidence: 99%

Modern diagnosis ofTrichomonas vaginalisinfection

2013

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Recent advances in tests for the sexually transmitted protozoan parasite Trichomonas vaginalis have increased opportunities for diagnosis and treatment of this important sexually transmitted infection. This review summarises currently available tests, highlighting their performance characteristics, advantages and limitations. The recent development of molecular tests for the detection of T vaginalis, including rapid antigen detection and nucleic acid amplification tests, has significantly improved the quality of diagnostics for trichomoniasis, particularly in women. In light of the expanded menu of testing options now available, improved recognition and better control of trichomoniasis are in sight, which should enable the eventual reduction of adverse reproductive consequences associated with T vaginalis infection.

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“…Although we did not identify flagella in the trichomonads in our case, the finding of flagella, while helpful, is not always required to make a diagnosis of Trichomonas [1]. In fact, the morphologic identification of Trichomonas on liquid-based Pap tests has been shown to be highly accurate [2]. Nevertheless, exfoliated cells including microorganisms in urine are often degenerated, which makes the identification of Trichomonas in these specimens by morphology alone difficult.…”

Section: Articlementioning

confidence: 93%