Human Papillomaviruses and genital co-infections in gynaecological outpatients

Department of Gynaecology, Perinatology and Child Health, Sapienza University of Rome, Italy.
BMC Infectious Diseases (Impact Factor: 2.61). 03/2009; 9(1):16. DOI: 10.1186/1471-2334-9-16
Source: PubMed


High grade HPV infections and persistence are the strongest risk factors for cervical cancer. Nevertheless other genital microorganisms may be involved in the progression of HPV associated lesions.
Cervical samples were collected to search for human Papillomavirus (HPV), bacteria and yeast infections in gynaecologic outpatients. HPV typing was carried out by PCR and sequencing on cervical brush specimens. Chlamydia trachomatis was identified by strand displacement amplification (SDA) and the other microorganisms were detected by conventional methods.
In this cross-sectional study on 857 enrolled outpatients, statistical analyses revealed a significant association of HPV with C. trachomatis and Ureaplasma urealyticum (at high density) detection, whereas no correlation was found between HPV infection and bacterial vaginosis, Streptococcus agalactiae, yeasts, Trichomonas vaginalis and U. urealyticum. Mycoplasma hominis was isolated only in a few cases both in HPV positive and negative women and no patient was infected with Neisseria gonorrhoeae.
Although bacterial vaginosis was not significantly associated with HPV, it was more common among the HPV positive women. A significant association between HPV and C. trachomatis was found and interestingly also with U. urealyticum but only at a high colonization rate. These data suggest that it may be important to screen for the simultaneous presence of different microorganisms which may have synergistic pathological effects.

Download full-text


Available from: Alessandra Pierangeli
  • Source
    • "Nevertheless, there is epidemiologic data suggesting that Chlamydia trachomatis may contribute in cervical carcinogenesis [Silins et al., 2005] although how it synergizes with HPV in the transforming process is still debated [Idahl et al., 2010]. It is worth noting that due to the same modality of transmission, Chlamydia trachomatis and HPV co-infection, is increasing in sexually active females and therefore early diagnosis and treatment of infected subjects is required to prevent the spread of the infections and possible sequelae [Verteramo et al., 2009]. In this context, the availability of a highly sensitive and specific molecular technique could improve the "
    [Show abstract] [Hide abstract]
    ABSTRACT: Chlamydia trachomatis causing chronic inflammatory diseases has investigated as possible human papillomavirus (HPV) cofactor in cervical cancer. The aim of this study is to evaluate the prevalence of Chlamydia trachomatis and HPV co-infection in different cohorts of asymptomatic women from a Northern Italy area at high incidence for cervical cancer. Cervical samples from 441 females were collected from Cervical Cancer Screening Program, Sexually Transmitted Infectious and Assisted Reproductive Technology centres. HPV and Chlamydia trachomatis were detected simultaneously and genotyped using a highly sensitive bead based assay. The overall prevalence of Chlamydia trachomatis was estimated 9.7%, in contrast with the reported national data of 2.3%, and co-infection with HPV was diagnosed in the 17% of the samples. In females ≤ 25 years of age, the infection reached a peak of 22% and co-infection with HPV of 45.8% (P < 0.001). Of note, in young females diagnosed with low grade cervical lesions, no significant difference between Chlamydia trachomatis and HPV distribution was observed, while differently, HPV co-infection was found significantly associated to the presence of intraepithelial lesions when compared to older females (20% vs. 1%; P < 0.001). In this study, the use of a high sensitive molecular technique exhibited higher analytical sensitivity than the referred assays for the diagnosis of Chlamydia trachomatis and HPV co-infection in asymptomatic females, leading to reduction of the potential to identify incorrectly the infection status. An active screening for timely treatment of Chlamydia trachomatis infection is suggested in young females to evaluate a possible decrease in incidence of pre-cancer intraepithelial lesions. J. Med. Virol. © 2014 Wiley Periodicals, Inc.
    Full-text · Article · Aug 2014 · Journal of Medical Virology
  • Source
    • "CT infection has been reported to increase the risk of developing squamous cell carcinoma of the cervix56. This association has been demonstrated using polymerase chain reaction (PCR) results6 as well as antibody titres7 as a measure of CT infection. A higher prevalence of CT infection in HPV positive samples when compared to HPV negative samples has been reported in several studies89. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background & objectives: Human papillomavirus (HPV) is the necessary cause of cervical cancer and Chlamydia trachomatis (CT) is considered a potential cofactor in the development of cervical intraepithelial neoplasia (CIN). The objective of this pilot study was to determine the association of CT infection with HPV, other risk factors for cervical cancer, and CIN in symptomatic women. Methods: A total of 600 consecutively selected women aged 30-74 yr with persistent vaginal discharge, intermenstrual/postcoital bleeding or unhealthy cervix underwent conventional Pap smear, Hybrid Capture 2® (HC2) testing for HPV and CT DNA and colposcopy, with directed biopsy of all lesions. Results: HPV DNA was positive in 108 (18.0%) women, CT DNA in 29 (4.8%) women. HPV/CT co-infection was observed in only four (0.7%) women. Of the 127 (21.2%) women with Pap >ASCUS, 60 (47.2%) were HPV positive and four (3.1%) were CT positive. Of the 41 women with CIN1 lesions, 11 (26.8%) were HPV positive, while two were CT positive. Of the 46 women with CIN2+ on histopathology, 41 (89.1%) were HPV positive, two (4.3%) were CT positive and one was positive for both. The risk of CIN2+ disease was significantly increased (P<0.05) by the following factors: age <18 yr at first coitus, HPV infection and a positive Pap smear. Older age (>35 yr), higher parity, use of oral contraceptives or smoking did not show any significant association with HPV or abnormal histopathology. Parity >5 was the only risk factor positivity associated with CT infection (P<0.05). Interpretation & conclusions: Our findings showed that CT infection was not significantly associated with CIN, and most of its risk factors, including HPV infection, in symptomatic women. Longitudinal studies with carefully selected study sample would be able to answer these questions.
    Full-text · Article · Mar 2013 · The Indian Journal of Medical Research
  • Source
    • "Microorganisms infecting the lower genital tract can be transported to the uterus and the Fallopian tubes either by (1) ascending to cause endometritis and subsequent salpingitis or (2) transport by the lymphatic system (Brook, 2002). Bacterial vaginosis has been associated with genital and obstetric infections, including PID (Catlin, 1992; Hay et al., 1992; Soper, 1994), particularly in the presence of other sexually transmitted infections (Hillier et al., 1996; Wiesenfeld et al., 2002) including human papilloma virus infections (Verteramo et al., 2009). Gaudoin et al., (Gaudoin et al., 1999) reported a strong association between bacterial vaginosis and tubal factor infertility and in a study by Wilson and colleagues (2002) it was concluded that women with tubal infertility were three times more likely to have bacterial vaginosis than women with male factor or unexplained infertility. "

    Preview · Chapter · Oct 2011
Show more