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Gardnerella vaginalis and Trichomonas vaginalis infections and the risk of persistence or progression of low-grade cervical intraepithelial neoplasia. Pathol Res Pract 2020; 216:153234. [PMID: 33075741 DOI: 10.1016/j.prp.2020.153234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022]
Abstract
Gardnerella vaginalis (GV) and Trichomonas vaginalis (TV) infections have been proposed as risk factors for persistence or progression of low-grade precancerous cervical lesions (CIN1/L-SIL). However, their role is still undefined. We aimed to assess if GV and TV infections affect the risk of persistence/progression of CIN1/L-SIL. A retrospective cohort study was performed to assess the risk of CIN1/L-SIL persistence or progression, persistence alone and progression alone in patients with GV and/or TV infections (GV + and/or TV+), only GV (GV+), only TV (TV+), or GV and TV coinfections compared to patients without these infections. Relative risk (RR) with 95 % confidence intervals (CI) was adopted (significant p-value>0.05). Two hundred and seventy patients were included. RR for CIN1/L-SIL persistence or progression was 1.63 in GV + and/or TV+ (p = 0.02), 1.99 in GV+ (p = 0.0008), 0.25 in TV+ (p = 0.32), 1.78 in coinfection (p = 0.26). RR for persistence was 1.55 in GV + and/or TV+ (p = 0.1), 2.179 in GV+ (p = 0.0013), 0.32 in TV+ (p = 0.41), 0.45 in coinfection (p = 0.55). RR for progression was 1.92 in GV + and/or TV+ (p = 0.22), 1.34 in GV+ (p = 0.68), 1.16 in TV+ (p = 0.91), 8.39 in coinfection (p = 0.0002). In conclusion, GV infection may be a risk factor for CIN1/L-SIL persistence. TV infection alone does not significantly affect the risk of persistence or progression of such lesions, while it may greatly increase the risk of progression when associated with GV infection.
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Kayikcioglu F, Kucukyildiz IA, Gunes M, Özelci R, Dilbaz B, Dilbaz S. Relationship between contraceptive methods and human papillomavirus positivity. Arch Gynecol Obstet 2020; 302:1407-1412. [PMID: 32880708 DOI: 10.1007/s00404-020-05754-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/21/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Understanding the effect of contraceptive use on high-risk human papillomavirus (HPV) positivity may provide information that is valuable to women in contraceptive decision-making. This study includes women aged 30-65 years who admitted to Family Planing outpatient clinic and have hrHPVDNA positivity. METHODS We included a total of 801 women. All participants underwent national cervical cancer screening using HPV screening test conducted by the Cancer Control Department of the Ministry of Health. They completed a questionnaire on demographic information and potential risk factors. RESULTS The HPV DNA positivity rate among all participants was 8.4%. The two most common HPV genotypes were HPV16 and HPV51. Meanwhile, hrHPV infection was associated with age, marital status, smoking status, and contraceptive method. CONCLUSION HPV is the most common cause of sexually transmitted diseases. Understanding about the reproductive and demographic characteristics affecting HPV persistence is crucial. The effect of contraceptive methods on HPV positivity is important information that is necessary to be relayed to women by healthcare professionals.
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Affiliation(s)
- Fulya Kayikcioglu
- Department of Obstetrics and Gynecology, University of Medical Sciences, Etlik Zubeyde Hanım Training and Research Hospital, Ankara, Turkey
| | - Irem Alyazici Kucukyildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, İmaret/Sivas, Merkez/Sivas, 58140, Sivas, Turkey.
| | - Müzeyyen Gunes
- Department of Obstetrics and Gynecology, University of Medical Sciences, Etlik Zubeyde Hanım Training and Research Hospital, Ankara, Turkey
| | - Runa Özelci
- Department of Obstetrics and Gynecology, University of Medical Sciences, Etlik Zubeyde Hanım Training and Research Hospital, Ankara, Turkey
| | - Berna Dilbaz
- Department of Obstetrics and Gynecology, University of Medical Sciences, Etlik Zubeyde Hanım Training and Research Hospital, Ankara, Turkey
| | - Serdar Dilbaz
- Department of Obstetrics and Gynecology, University of Medical Sciences, Etlik Zubeyde Hanım Training and Research Hospital, Ankara, Turkey
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Bohbot JM, Brami G, Goubard A, Harvey T. [Ten questions about bacterial vaginosis]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:693-702. [PMID: 32438010 DOI: 10.1016/j.gofs.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Indexed: 06/11/2023]
Abstract
The physiopathology of bacterial vaginosis (BV), the ultimate stage of vaginal dysbiosis, has benefited from recent advances in molecular biology, highlighting, among others, the important role of A. vaginae. Certain immunological specificities (variants of TLR4, elevation of IL-1β, for example) explain the variations in the prevalence of this infection, the poor clinical and cellular inflammatory response and the promoting influence of BV on the acquisition and progression of some sexually transmitted infections. These advances do not fully elucidate the causes of the high rate of recurrences. Some risk factors for relapses of BV have been identified such as tobacco use, stress or hygienic errors have been associated to relapses of BV. However, other paths are beginning to be explored such as the role of sexual transmission, the resistance of certain bacteria associated to BV to nitroimidazoles or the lack of efficacy of conventional treatments on dysbiosis itself. Taking into acount this vaginal dysbiosis appears to be important or even essential to better control the natural history of HPV-hr infection or improve the success rate of IVF, for example. Despite heterogeneous results, the use of probiotics as a complement to conventional treatments (nitroimidazoles, dequalinium chloride) has demonstrated a preventive effect on BV recurrences. Further studies are needed to customize the contribution of probiotics (or synbiotics) according to the individual specificities of the vaginal microbiome.
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Affiliation(s)
- J-M Bohbot
- Institut Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France.
| | - G Brami
- Institut Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France
| | - A Goubard
- Institut Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France
| | - T Harvey
- Maternité des Diaconnesses, 12-18, rue du Sergent Bauchat, 75012 Paris, France
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Liu J, Luo M, Zhang Y, Cao G, Wang S. Association of high-risk human papillomavirus infection duration and cervical lesions with vaginal microbiota composition. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1161. [PMID: 33241010 PMCID: PMC7576078 DOI: 10.21037/atm-20-5832] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Cervical cancer is reportedly caused by the synergistic effects of persistent high-risk human papillomavirus (HPV) infection. Cervical microbiota represent a unique and dynamically changing microecological system that is directly exposed to the vagina. The relationship between HPV and the composition of the cervical microbiome has long been a primary focus of research. Methods To determine the specific differential florae throughout the process of cervical cancer development, in the present study, 16S rRNA sequencing was combined with KEGG pathway enrichment analysis to analyse five groups of cervical scraping samples with increasing durations of HPV infection and cervical intraepithelial neoplasia pathological classification. Results The findings revealed that decreasing levels of probiotics, including Shuttleworthia, Prevotella, Lactobacillus, and Sneathia, and increasing levels of pathogenic bacteria, including Dispar, Streptococcus, and Faecalibacterium prausnitzii, could be the direct result of early HPV infection. Other pathogenic bacteria, such as Bifidobacteriaceae, might represent key factors in cancer progression. Additionally, KEGG pathway enrichment analysis indicated that HPV infection directly inhibits multiple pathways, including those of sporulation, porphyrin and chlorophyll metabolism, arginine and proline metabolism, isoquinoline alkaloid biosynthesis, and ansamycin biosynthesis, which may lead to the development of early symptoms of cervical cancer. Biomarkers were predicted based on operational taxonomic unit (OTU) abundance data, and OTU851726 and OTU715913 were undoubtedly the best potential indicators of cervical cancer. Conclusions The findings of the present study could assist with the development of a guideline for screening new clinical drugs for cervical cancer.
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Affiliation(s)
- Jun Liu
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Mei Luo
- Department of Obstetrics and Gynecology, Lu-He Teaching Hospital, Capital Medical University, Beijing, China
| | - Yang Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guangming Cao
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuzhen Wang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Donmez HG, Sahal G, Akgor U, Cagan M, Ozgul N, Beksac MS. The relationship between the presence of HPV infection and biofilm formation in cervicovaginal smears. Infection 2020; 48:735-740. [PMID: 32623704 DOI: 10.1007/s15010-020-01478-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/30/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE To demonstrate and understand the association of HPV infection and biofilm formation. METHODS The study consisted of cervicovaginal samples of 72 women who were evaluated at the colposcopy unit. Papanicolaou staining was used for cytological examination while "Crystal Violet Binding" assay was performed to detect biofilm formation. RESULTS HPV-DNA was positive in 55.5% (n = 40) of the patients. The biofilm formation rate was statistically significantly higher in the HPV-positive women (45%) compared to HPV-negative women (21.9%) (P < 0.05). There was a statistically significant relationship between the presence of single HPV and "high-risk HPV" types and biofilm formation (P < 0.05). Biofilm formation was found in 80% of women with abnormal smear demonstrating atypical epithelial cells (P < 0.05). CONCLUSION Biofilm formation is more frequent at the cervicovaginal microbiota of patients with HPV infection. This finding is especially important in cases with atypical epithelial cells at their cervicovaginal smears.
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Affiliation(s)
- Hanife Guler Donmez
- Department of Biology, Faculty of Science, Hacettepe University, Beytepe, 06800, Ankara, Turkey.
| | - Gulcan Sahal
- Department of Biology, Faculty of Science, Hacettepe University, Beytepe, 06800, Ankara, Turkey
| | - Utku Akgor
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Cagan
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Ozgul
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mehmet Sinan Beksac
- Department of Gynecology and Obstetrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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56
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Huang Y, Wu X, Lin Y, Li W, Liu J, Song B. Multiple sexual partners and vaginal microecological disorder are associated with HPV infection and cervical carcinoma development. Oncol Lett 2020; 20:1915-1921. [PMID: 32724435 PMCID: PMC7377087 DOI: 10.3892/ol.2020.11738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022] Open
Abstract
There is an indirect link between multiple sexual partners (MSP) and cervical intraepithelial neoplasia (CIN) or even cervical cancer (CC). MSP may also lead to bacterial vaginosis (BV). The relationship among MSP, BV, human papillomavirus (HPV) infection and CIN/CC development in Chinese women remains unclear. The present study was designed to clarify their association. The study retrospectively analyzed 549 female patients who had visited a physical examination center. The MSP information was acquired, and vaginal microecology, HPV and cervical conization pathology (CCP) tests were performed when necessary. MSP status was distinct among patients with different levels of BV severity. In addition, as the severity of BV progressed, the HPV-positive ratio increased. Meanwhile, MSP was significantly associated with a positive HPV outcome, including HPV 16, HPV 18 and other high-risk HPV infections. The MSP group had a significantly higher percentage of positive CCP outcomes (particularly cases with CIN-II and CIN-III). Similarly, higher BV severity meant more severe CIN/CC progression. A logistic regression model based on age, MSP status and the Nugent score level was used in order to predict the CCP outcome. Furthermore, a receiver operating characteristic curve analysis resulted in an area under the curve of 0.834. In conclusion, the combination of MSP information and BV examination may provide a rapid, economic and accurate prediction of CIN/CC. Health education on sexual behavior and timely detection/treatment of BV should be conducted to reduce the risk of CC.
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Affiliation(s)
- Yu Huang
- Department of Obstetrics and Gynecology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Xinzhi Wu
- Department of Obstetrics and Gynecology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Ying Lin
- Department of Pathology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Wenzhou Li
- Department of Obstetrics and Gynecology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Jiahua Liu
- Department of Obstetrics and Gynecology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
| | - Baozhi Song
- Department of Obstetrics and Gynecology, Shengli Clinical Medical College of Fujian Medical University and Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
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Liang Y, Chen M, Qin L, Wan B, Wang H. Correction to: A meta-analysis of the relationship between vaginal microecology, human papillomavirus infection and cervical intraepithelial neoplasia. Infect Agent Cancer 2019; 14:47. [PMID: 31827598 PMCID: PMC6900842 DOI: 10.1186/s13027-019-0258-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Yuejuan Liang
- The Department of Gynecological of Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning City, 530021 China
| | - Mengjie Chen
- The Department of Gynecological of Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning City, 530021 China
| | - Lu Qin
- The Department of Gynecological of Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning City, 530021 China
| | - Bing Wan
- The Department of Gynecological of Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning City, 530021 China
| | - He Wang
- The Department of Gynecological of Guangxi Medical University Cancer Hospital, Guangxi Zhuang Autonomous Region, Nanning City, 530021 China
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