RESUMO
OBJECTIVE: The present report investigated the rates of coinfections between high-rik human papillomavirus (hrHPV) and the most important human mycoplasmas including Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum in cervical samples of asymptomatic brazilian population. METHODS: Were included a total of 283 women aged 25-64 years screened by Papanicolaou smears for determining cervical abnormalities, single-target polymerase chain reaction (PCR) and real-time PCR (rt-PCR) for hrHPV and mycoplasmas, respectively. RESULTS: A total of 273 (94.5%) women were negative for intraepithelial lesions or malignancy cytology (NILM) and 10 (3.5%) presented abnormal cytology, all low-grade intraepithelial lesions (LSIL). The prevalence of hrHPV was 12.7% and 53.7% for mycoplasmas. U. parvum was the most frequently bacteria detected, followed by Mycoplasma hominis and U. urealyticum. M. genitalium was not detected. Women positive for U. parvum presented a 5-fold increased risk of LSIL (OR = 5.33; 95% CI = 1.09-26.04, P = 0.02) and co-infections between U. parvum and hrHPV increased the risk for LSIL (OR = 3.88; 95% CI = 1.75-8.58, P = 0.0003). However, these associations were not dependent on the concentration of the bacteria. CONCLUSION: Our results reinforced the hypothesis that some mycoplasmas may play a role as cofactors in HPV-mediated cervical carcinogenesis, at least in some populations.
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Assuntos
Coinfecção/complicações , Infecções por Mycoplasma/complicações , Infecções por Papillomavirus/complicações , Lesões Intraepiteliais Escamosas Cervicais/microbiologia , Lesões Intraepiteliais Escamosas Cervicais/patologia , Infecções por Ureaplasma/complicações , Adulto , Alphapapillomavirus , Brasil , Coinfecção/patologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Mycoplasma/patologia , Mycoplasma hominis , Infecções por Papillomavirus/patologia , Ureaplasma , Infecções por Ureaplasma/patologiaRESUMO
OBJECTIVE: The aim of this study was to assess the correlation between atypical squamous cells (ASC) and inflammatory infiltrate and vaginal microbiota using cervical liquid-based cytological (SurePath®) and high-risk human papillomavirus (HR-HPV) tests. STUDY DESIGN: A cross-sectional study was conducted using a 6-year database from a laboratory in Fortaleza (Brazil). Files from 1,346 ASC cases were divided into subgroups and results concerning inflammation and vaginal microorganisms diagnosed by cytology were compared with HR-HPV test results. RESULTS: An absence of specific microorganisms (ASM) was the most frequent finding (ASC of undetermined significance, ASC-US = 74%; ASC - cannot exclude high-grade squamous intraepithelial lesion, ASC-H = 68%), followed by bacterial vaginosis (ASC-US = 20%; ASC- H = 25%) and Candida spp. (ASC-US = 6%; ASC-H = 5%). Leukocyte infiltrate was present in 71% of ASC-US and 85% of ASC-H (p = 0.0040), and in these specific cases HR-HPV tests were positive for 65 and 64%, respectively. A positive HR-HPV test was relatively more frequent when a specific microorganism was present, and Candida spp. was associated with HR-HPV-positive results (p = 0.0156), while an ASM was associated with negative HR-HPV results (p = 0.0370). CONCLUSION: ASC-US is associated with an absence of inflammation or vaginosis, while ASC-H smears are associated with Trichomonas vaginalis and inflammatory infiltrate. A positive HR-HPV is associated with Candida spp. in ASC cytology.
Assuntos
Células Escamosas Atípicas do Colo do Útero/patologia , Testes de DNA para Papilomavírus Humano , Técnicas Microbiológicas , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , RNA Viral/genética , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/patologia , Vaginite/patologia , Adulto , Células Escamosas Atípicas do Colo do Útero/microbiologia , Células Escamosas Atípicas do Colo do Útero/parasitologia , Células Escamosas Atípicas do Colo do Útero/virologia , Brasil , Candida/isolamento & purificação , Candidíase Vulvovaginal/microbiologia , Candidíase Vulvovaginal/patologia , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Leucócitos/patologia , Biópsia Líquida , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Valor Preditivo dos Testes , RNA Viral/isolamento & purificação , Fatores de Risco , Lesões Intraepiteliais Escamosas Cervicais/microbiologia , Lesões Intraepiteliais Escamosas Cervicais/parasitologia , Lesões Intraepiteliais Escamosas Cervicais/virologia , Vaginite por Trichomonas/parasitologia , Vaginite por Trichomonas/patologia , Trichomonas vaginalis/isolamento & purificação , Neoplasias do Colo do Útero/microbiologia , Neoplasias do Colo do Útero/parasitologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal , Vaginite/microbiologia , Vaginite/parasitologia , Adulto JovemRESUMO
The influence of different infectious agents and their association with human papillomavirus (HPV) in cervical carcinogenesis have not been completely elucidated. This study describes the association between cytological changes in cervical epithelium and the detection of the most relevant aetiological agents of sexually transmitted diseases. Samples collected from 169 patients were evaluated by conventional cytology followed by molecular analysis to detect HPV DNA, Chlamydia trachomatis, herpes simplex virus 1 and 2,Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, andTreponema pallidum, besides genotyping for most common high-risk HPV. An association between cytological lesions and different behavioural habits such as smoking and sedentariness was observed. Intraepithelial lesions were also associated with HPV and C. trachomatis detection. An association was also found between both simple and multiple genotype infection and cytological changes. The investigation of HPV and C. trachomatisproved its importance and may be considered in the future for including in screening programs, since these factors are linked to the early diagnosis of patients with precursor lesions of cervical cancer.
Assuntos
Colo do Útero/microbiologia , Chlamydia trachomatis/isolamento & purificação , DNA Viral/isolamento & purificação , Papillomaviridae/isolamento & purificação , Lesões Intraepiteliais Escamosas Cervicais/microbiologia , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Carcinogênese , Colo do Útero/patologia , Infecções por Chlamydia/complicações , Infecções por Chlamydia/epidemiologia , Coinfecção , Estudos Transversais , Efeito Citopatogênico Viral , Detecção Precoce de Câncer/métodos , Epitélio/virologia , Feminino , Genótipo , Técnicas de Genotipagem , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Tipagem Molecular , Mycoplasma genitalium/isolamento & purificação , Neisseria gonorrhoeae/isolamento & purificação , Papillomaviridae/classificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Fatores de Risco , Treponema pallidum/isolamento & purificação , Trichomonas vaginalis/isolamento & purificação , Neoplasias do Colo do Útero/microbiologia , Adulto JovemRESUMO
The influence of different infectious agents and their association with human papillomavirus (HPV) in cervical carcinogenesis have not been completely elucidated. This study describes the association between cytological changes in cervical epithelium and the detection of the most relevant aetiological agents of sexually transmitted diseases. Samples collected from 169 patients were evaluated by conventional cytology followed by molecular analysis to detect HPV DNA, Chlamydia trachomatis, herpes simplex virus 1 and 2,Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, andTreponema pallidum, besides genotyping for most common high-risk HPV. An association between cytological lesions and different behavioural habits such as smoking and sedentariness was observed. Intraepithelial lesions were also associated with HPV and C. trachomatis detection. An association was also found between both simple and multiple genotype infection and cytological changes. The investigation of HPV and C. trachomatisproved its importance and may be considered in the future for including in screening programs, since these factors are linked to the early diagnosis of patients with precursor lesions of cervical cancer.