Association between asymptomatic sexually transmitted infections and high-risk human papillomavirus in cervical lesions / 西安交通大学学报(医学版)

ABSTRACT

Objective To determine the association of asymptomatic sexually transmitted infections (STIs) with high-risk human papillomavirus (hrHPV) in cervical squamous intraepithelial lesions and neoplasms. Methods From July 2017 to July 2018, 320 hrHPV-positive and 160 hrHPV-negative women in The First Affiliated Hospital of Xi'an Jiaotong University were divided into normal+low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL)+ invasive cervical cancer (ICC) subgroups, respectively, based on their pathological cervical lesion grades. Cervical brush specimens including Ureaplasma urealyticum (UU) and its serotypes, Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), and hrHPV were amplified and hybridized using PCR kits (Hybribio Biochemistry Co., Ltd.). The differences between groups were examined by the chi-squared test, continuity correction and Logistic regression. Results The overall infection (at least one of the non-hrHPV pathogens was positive) rates of the two groups were 62.5% and 59.4%, which were not significantly different. The prevalence of UU was the highest. The prevalence of UU serotype 14 (Uup14) and MH was associated with hrHPV (P=0.003, P=0.005, respectively), but not with certain hrHPV genotypes or with single or multiple genotypes. Compared with cases of normal+LSIL, cases of HSIL+ICC had significantly different Uup14 infection rates (OR 12.579, 95% CI 3.638-43.497, P<0.001) in the positive group. In hrHPV-negative cases, there were obvious differences in Uuu and Uup1 infections based on different cervical lesion types (OR 11.646, 95% CI 1.493-90.850, P=0.019; OR 7.474, 95% CI 1.140-49.015, P=0.036). Conclusion Asymptomatic STIs in female lower reproductive tract are widespread. Uup14 may increase the risk of HSIL+ICC when hrHPV is positive. Uuu and Uup1 cause an increased risk of HSIL+ICC without hrHPV.