Human Papillomaviruses and genital co-infections in gynaecological outpatients

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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. <it>Chlamydia trachomatis </it>was identified by strand displacement amplification (SDA) and the other microorganisms were detected by conventional methods.</p> <p>Results</p> <p>In this cross-sectional study on 857 enrolled outpatients, statistical analyses revealed a significant association of HPV with <it>C. trachomatis </it>and <it>Ureaplasma urealyticum (</it>at high density) detection, whereas no correlation was found between HPV infection and bacterial vaginosis, <it>Streptococcus agalactiae</it>, yeasts, <it>Trichomonas vaginalis </it>and <it>U. urealyticum</it>. <it>Mycoplasma hominis </it>was isolated only in a few cases both in HPV positive and negative women and no patient was infected with <it>Neisseria gonorrhoeae</it>.</p> <p>Conclusion</p> <p>Although bacterial vaginosis was not significantly associated with HPV, it was more common among the HPV positive women. A significant association between HPV and <it>C. trachomatis </it>was found and interestingly also with <it>U. urealyticum </it>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.</p