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A D, Li J, Zhang D, Xiao B, Bi H. Status of common sexually transmitted infection in population referred for colposcopy and correlation with human papillomavirus infection. BMC Womens Health 2023; 23:579. [PMID: 37940891 PMCID: PMC10634156 DOI: 10.1186/s12905-023-02693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND To investigate the prevalence of common sexually transmitted infections (STIs) and the association of STI/human papillomavirus co-infection in young and middle-aged women with previous abnormal cervical findings referred for colposcopy. METHODS 719 cervical-swab cytobrush specimens were obtained from women aged ≤ 50 years who were referred for colposcopy at Peking University First Hospital due to previous abnormal cervical findings. HPV 21 typing and a panel of pathogenic STIs were tested for using the 21 HPV GenoArray Diagnostic Kit (HBGA-21PKG; HybriBio, Ltd., Chaozhou, China) and a nucleic acid STI detection kit (HybriBio Ltd. Guangzhou, China), after which colposcopy with multipoint positioning biopsy was performed. RESULTS The overall prevalence of STIs among HPV positive women with previous abnormal cervical cancer screening results was 63.7% (458/719), with Ureaplasma parvum serovar 3, Ureaplasma parvum serovar 6 and herpes simplex virus type 2 having significantly higher prevalence among high-risk HPV positive patients (19.3%, Χ2 = 5.725, P = 0.018; 21.5%, Χ2 = 4.439, P = 0.035; 5.7%, Χ2 = 4.184, P = 0.048). Among patients positive for the high-risk human papillomavirus, the prevalence of Neisseria gonorrhoeae infection in human papillomavirus 16/18 positive patients was significantly higher than that in other patients (2.5%, Χ2 = 4.675; P = 0.043). Histopathologically, Chlamydia trachomatis infection was more frequently detected in lower than or equal to low-grade squamous intraepithelial lesion infection status (13.0%, Χ2 = 3.368; P = 0.041). CONCLUSIONS The high prevalence of HPV coinfection with other sexually transmitted pathogens, particularly Ureaplasma parvum serovar 3, Ureaplasma parvum serovar 6, and herpes simplex virus type 2, calls for routine STI screening and effective STI prevention and management in patients with abnormal cervical cancer screening results.
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Affiliation(s)
- Disi A
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China
| | - Jiayue Li
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Dai Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China
| | - Bingbing Xiao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China.
| | - Hui Bi
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China.
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Lu Z, Zhao P, Lu H, Xiao M. Analyses of human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and co-infections in a gynecology outpatient clinic in Haikou area, China. BMC Womens Health 2023; 23:117. [PMID: 36944923 PMCID: PMC10029165 DOI: 10.1186/s12905-023-02259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The purpose of this study was to study the infection rates of Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Neisseria gonorrhoeae (NG), and co-infections with human papillomavirus (HPV) in a hospital gynecology outpatient clinic in the Haikou region in 2021. METHODS From January to December 2021, the Women and Children Medical Center of Hainan Province collected 2389 samples of cervical exfoliated cells and vaginal swab specimens from gynecologic outpatients. The samples were then analyzed descriptively for data, and the detection rate of each pathogen was tallied. All vaginal swabs were obtained for CT, UU, and NG DNA testing, and cervical exfoliated cells for HPV genotyping. Analyses were performed on the detection rate of each group. RESULTS In 2389 samples, the frequencies of pathogen identification among the 2389 samples were as follows: UU (58.43%); HPV (17.29%); CT (7.99%); and NG (0.38%). HPV, CT, UU, and NG were detected in 33.33%, 22.55%, 77.45%, and 2.94% of individuals between 15 and 20 years of age, respectively. The detection rates of CT, UU, and NG were substantially greater in the HPV-positive group than the the HPV-negative group (P < 0.05). CONCLUSION Among gynecologic outpatients at a hospital in the Haikou area, the probability of mixed infections with genital tract pathogens in HPV-positive patients was higher compared to HPV-negative patients. Reproductive tract infections are becoming more prevalent in younger people, hence adolescent sexual health education needs improvement.
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Affiliation(s)
- Zhe Lu
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Peizhen Zhao
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Huijun Lu
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China
| | - Meifang Xiao
- Clinical Laboratory, Women and Children's Health Care Center of Hainan, 75 Longkun Nan Road, Haikou City, 570100, Hainan Province, China.
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A D, Bi H, Zhang D, Xiao B. Association between human papillomavirus infection and common sexually transmitted infections, and the clinical significance of different Mycoplasma subtypes. Front Cell Infect Microbiol 2023; 13:1145215. [PMID: 37009504 PMCID: PMC10061082 DOI: 10.3389/fcimb.2023.1145215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionHuman papillomavirus (HPV) infection, especially persistent high-risk HPV, is associated with cervical cancer. Female reproductive tract microecological disorders and lower genital tract infections have been increasingly correlated with HPV infection and cervical lesions. Due to their common risk factors and transmission routes, coinfection with other sexually transmitted infections (STIs) has become a concern. Additionally, the clinical significance of Mycoplasma subtypes appear to vary. This study aimed to assess the correlations between common STIs and HPV infection, and to investigate the clinical significance of Mycoplasma subtypes.MethodsWe recruited 1,175 patients undergoing cervical cancer screening at the Peking University First Hospital gynecological clinic from March 2021 to February 2022 for vaginitis and cervicitis tests. They all received HPV genotyping and detection of STIs, and 749 of them underwent colposcopy and cervical biopsy.ResultsAerobic vaginitis/desquamative inflammatory vaginitis and STIs (mainly single STIs) were found significantly more often in the HPV-positive group than in the HPV-negative group. Among patients with a single STI, rates of infection with herpes simplex virus type 2 or UP6 in the HPV-positive group were significantly higher than in the HPV-negative group (ORadj: 1.810, 95%CI: 1.211–2.705, P=0.004; ORadj: 11.032, 95%CI: 1.465–83.056, P=0.020, respectively).DiscussionThrough detailed Mycoplasma typing, a correlation was found between different Mycoplasma subtypes and HPV infection. These findings suggest that greater attention should be paid to detecting vaginal microecological disorders in those who are HPV-positive. Further, lower genital tract infections, including both vaginal infections and cervical STIs, are significantly more common among women who are HPV-positive and who thus require more thorough testing. Detailed typing and targeted treatment of Mycoplasma should become more routine in clinical practice.
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Sechi I, Elvezia CC, Martinelli M, Muresu N, Castriciano S, Sotgiu G, Piana A. Comparison of Different Self-Sampling Devices for Molecular Detection of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs): A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10030459. [PMID: 35326937 PMCID: PMC8950387 DOI: 10.3390/healthcare10030459] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Cervical cancer is the fourth most common cancer in women, and it is well known that high-risk human papillomavirus (hrHPV) infections are the necessary carcinogenic factors for the development of cervical tumors. Moreover, the interaction between HPV and other sexually transmitted infections (STIs) may increase the risk of cancer progression. Self-sampling has been demonstrated to represent a valid and well-accepted alternative, favoring women’s participation in screening programs. This study aimed to investigate the use of FLOQSwabs® (FS) as compared to two other vaginal self-collection devices for the detection of hrHPV and other sexually transmitted infections. Methods: Cervical and vaginal self-samples were collected, using two different combinations of vaginal self-sampling devices, from 40 women referred to colposcopy for a documented abnormal Pap smear. All samples were tested for hrHPV and seven STI pathogens using two commercial molecular assays. Results: Data on hrHPV detection from the first group of women showed an almost perfect agreement (kappa: 0.89) between cervical vs. FS vaginal self-samples, and a substantial agreement (kappa: 0.79) between cervical and HerSwab™ (HS) samples. In the second group of women, an almost perfect agreement (kappa: 0.90) was demonstrated in the detection of hrHPV between cervical samples vs. FS, and a moderate agreement (kappa: 0.60) for cervical vs. Evalyn®Brush (EB) self-collected samples. STI detections showed a very good agreement (kappa: 0.89 and kappa: 1.00) both among FS vs. HS and FS vs. EB, respectively. There was no statistically significant difference between the different devices used. The most frequently detected hrHPV genotypes in the studied population were HPV 16, 31, 35, 51, and 56; whilst the most frequently identified STI pathogens were Ureaplasma parvum and Mycoplasma hominis. Overall, investigated women did not report any discomfort in using the different vaginal self-collection devices. Conclusion: Evaluation of the three different vaginal self-collection devices confirmed their overall good acceptability by the studied population, as well as a similar agreement for hrHPV detection as compared to cervical samples. Our study indicated that the use of self-collected samples offers an alternative strategy to improve women’s participation in cervical cancer screening programs, but also underlined the importance of evaluating the concordance in hrHPV detection of collection devices in combination with the molecular hrHPV assay.
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Affiliation(s)
- Illari Sechi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street 4, 07029 Sassari, Italy; (I.S.); (N.M.); (A.P.)
| | - Cocuzza Clementina Elvezia
- Department of Medicine and Surgery, University of Milano-Bicocca, Cadore Street, 48, 20900 Milano, Italy;
- Correspondence:
| | - Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, Cadore Street, 48, 20900 Milano, Italy;
| | - Narcisa Muresu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street 4, 07029 Sassari, Italy; (I.S.); (N.M.); (A.P.)
| | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street 4, 07029 Sassari, Italy;
| | - Andrea Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Padre Manzella Street 4, 07029 Sassari, Italy; (I.S.); (N.M.); (A.P.)
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Xie L, Li Q, Dong X, Kong Q, Duan Y, Chen X, Li X, Hong M, Liu T. Investigation of the association between ten pathogens causing sexually transmitted diseases and high-risk human papilloma virus infection in Shanghai. Mol Clin Oncol 2021; 15:132. [PMID: 34055347 PMCID: PMC8138855 DOI: 10.3892/mco.2021.2294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/19/2021] [Indexed: 12/24/2022] Open
Abstract
Cervical cancer, one of the high-incidence female malignant tumors, has predominated in recent years. Persistent infection with high-risk human papillomavirus (HR-HPV) is the main cause of cervical cancer. Studies have shown that infection with certain sexually transmitted disease (STD) pathogens increases the risk of persistent infection with HR-HPV and is a high-risk factor for cervical cancer. In the present study, cervical specimens were collected for Thinprep cytology test detection, while DNA of cervical cells was extracted for HPV genotyping and detection of 10 STD pathogens, including Neisseria gonorrhoeae, Chlamydia trachomatis (CT), Ureaplasma urealyticum, Ureaplasma urealyticum parvum (Uup)1, Uup3, Uup6, Uup14, Mycoplasma hominis (Mh), Mycoplasma genitalium (Mg) and herpes simplex virus II. Significant differences were observed between CT, Mh and Mg infections and HR-HPV infection (P<0.05). In addition, CT, Uup3, Uup6 and Mh infections were associated with HR-HPV infection (odds ratio >1; P<0.05). In the comparison of Uup3, Uup6 and Mg infections between the cervical intraepithelial neoplasia (CIN) group and the control group, statistically significant differences were observed (P<0.05). In conclusion, the incidences of CT, Mh and Mg infections were similar with HR-HPV infection. CT, Uup6, Mh and Mg infections were risk factors for HR-HPV infection. Finally, Uup3, Uup6 and Mg were risk factors of CIN.
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Affiliation(s)
- Li Xie
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Qian Li
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Xiangrong Dong
- Ear, Nose and Throat Department, Shanghai Gongli Hospital, Shanghai 200940, P.R. China
| | - Qi Kong
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, Guangdong 510641, P.R. China
| | - Yuping Duan
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Xiong Chen
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Xiaoqiang Li
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Mao Hong
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
| | - Tao Liu
- Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University Wusong Hospital, Shanghai 200940, P.R. China
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Martinelli M, Musumeci R, Sechi I, Sotgiu G, Piana A, Perdoni F, Sina F, Fruscio R, Landoni F, Cocuzza CE. Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245000. [PMID: 31818033 PMCID: PMC6950209 DOI: 10.3390/ijerph16245000] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 01/03/2023]
Abstract
Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. Human Papillomavirus (HPV) infections are among the most prevalent STIs and persistent infections with high-risk HPV (hrHPV) genotypes can cause cervical dysplasia and invasive cervical cancer. The association of other STIs with HPV cervical infection and/or dysplasia has however not yet been fully elucidated. The aim of this study was to assess the prevalence of HPV and other STIs among women presenting with an abnormal cervical cytology. Cervical infections with 28 HPV genotypes and seven other sexually transmitted pathogens were evaluated in 177 women referred for a colposcopy after an abnormal Pap smear. Positivity for at least one hrHPV genotype was shown in 87% of women; HPV 16 was the most prevalent (25.0%), followed by HPV 31 and HPV 51. The overall positivity for other STIs was 49.2%, with Ureaplasma parvum being the most prevalent microrganism (39.0%). Co-infections between hrHPV and other STIs were demonstrated in 17.5% of women; no significant association was demonstrated between multiple infections and the colposcopy findings. This study provides new epidemiological data on the prevalence of cervical infections associated with HPV and seven other common sexually transmitted pathogens in a population of women presenting with an abnormal cervical cytology.
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Affiliation(s)
- Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
| | - Rosario Musumeci
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
| | - Illari Sechi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (I.S.); (G.S.); (A.P.)
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (I.S.); (G.S.); (A.P.)
| | - Andrea Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (I.S.); (G.S.); (A.P.)
| | - Federica Perdoni
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
| | - Federica Sina
- ASST Monza, San Gerardo Hospital, 20900 Monza, Italy;
| | - Robert Fruscio
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
- ASST Monza, San Gerardo Hospital, 20900 Monza, Italy;
| | - Fabio Landoni
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
- ASST Monza, San Gerardo Hospital, 20900 Monza, Italy;
| | - Clementina E. Cocuzza
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy; (M.M.); (R.M.); (F.P.); (R.F.); (F.L.)
- Correspondence:
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