Associação entre papilomavírus humano, vaginose bacteriana e inflamação cervical e a detecção de anormalidades no exame citológico de adolescentes e mulheres jovens
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2014-06-24
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Universidade Federal de Goiás
Resumo
HPV, BV and CI are common conditions in adolescents and young women. Studies have
reported that BV and CI can be cofactors for the acquisition and persistence of HPV, enabling
the development of cytological abnormalities precursor of cervical cancer. The aim of this
study was to estimate the prevalence of HPV, BV and IC in adolescents and young women
and to verify that these conditions are associated with the detection of cytological
abnormalities in cervical smears in adolescents and young women. Were included samples of
sexually active patients and users of the Unified Health System (SUS) who underwent
cervical screening by the conventional method. The cervical specimens were analyzed at the
Center for Clinical Analysis Rômulo Rocha, Faculty of Pharmacy/UFG, by qualified
professionals following strict quality control. The detection of HPV-DNA was made by PCR
using pools of primers PGMY09/PGMY11. The diagnosis of BV was established from the
observation of the presence of 20% or more of clue cells in cervical smears. The IC was
assessed by counting the number of leukocytes in cervical smears in five noncontiguous with
increased microscopic fields 1000X average, according Castle et al. (2001). Statistical
analyzes with hierarchical logistic and control of confounding variables regression model
were performed. The magnitude of association was estimated by calculating the odds ratio
(OR) with confidence intervals (CI*) of 95%. 251 samples were included, with 54,9%
(138/251) of adolescents aged between 15 and 19 years and 45,1% (113/251) of young
women aged between 20 and 25 years. Positive results for cytological abnormalities
accounted for 9,5% (24/251) of all cervical smears. The diagnosis of atypical squamous cells
of undetermined significance (atypical squamous cells of undetermined significance - ASCUS)
(50,0% 12/24) and squamous intraepithelial lesions (low grade squamous intraepithelial
lesion - LSIL) (29,1 % 7/24) were more frequent. The overall prevalence of HPV, BV, and CI
44,2% (111/251), 41,0% (103/251) and 83,2% (209/251), respectively. Of the variables
investigated, VB (OR = 2,46 CI*: 1,26 to 3,80; p: 0,006) and the detection of abnormal
cytological diagnosis (OR = 1.36 CI*: 1.07 to 1.74; p: 0.013) were associated with HPV
positivity in multivariate analysis. Whereas the detection of cytological abnormalities there
was a significant association with HPV and BV detected in the same patient (OR = 2,59 CI*:
1,09 to 6,20; p: 0,032) and for the detection of HPV, BV and CI together (OR = 3,58 CI*:
1,06 to 12,15; p: 0,040), however, they didn’t remain independently associated in bivariate
analysis. BV and cytological abnormalities were independently associated with HPV infection
in adolescents and young women. HPV, BV and CI in cervical smears can indicate high
possibility to detect cytological abnormalities in adolescents and young women.
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Palavras-chave
Papillomavirus humano , VB , Inflamação cervical , SIL , Adolescente , Adulto jovem , HPV , BV , Cervicitis , SIL , Adolescents and young adults
Citação
CAIXETA, R. C. A. Associação entre papilomavírus humano, vaginose bacteriana e inflamação cervical e a detecção de anormalidades no exame citológico de adolescentes e mulheres jovens. 2014. 79 f. Dissertação (Mestrado em Medicina Tropical e Saúde Pública) - Universidade Federal de Goiás, Goiânia, 2014.