Prevalência das infecções por Papilomavírus humano e soropositividade de Chlamydia trachomatis em mulheres portadoras de neoplasias cervicais na região central do Brasil
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2009-11-24
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Universidade Federal de Goiás
Resumo
High-risk papillomavirus (HPV) is the etiological agent for cervical neoplasia.
However, the presence of singly HPV infection is unlikely to be sufficient for cervical carcinogenesis, and other sexually transmitted infections (STI) may increase the risk of cervical neoplasia. The significance of the association between the human papillomavirus (HPV)
and other sexually transmitted infections in the development of cervical neoplasias has
been investigated and the more consistent data have pointed to an association with Chlamydia trachomatis (C. trachomatis). However, the exact relationship between C. trachomatis and HPV infection remains not completely understood. It is possible that C. trachomatis infection may be an independent factor or cofactor for HPV in the development of
cervical neoplasia. Objective: The objective of this study was to evaluate the seropositivity
for Chlamydia trachomatis in HPV-positive women correlating with the severity of cervical
neoplasia in central area of Brazil. Methodology: A total of 131 women referred to colposcopic clinic, in Goiás, Brazil because of an abnormal cervical smear were included in the
study. HPV DNA was detected by polymerase chain reaction using PGMY09/PGMY11 primers, and genotyping was performed by reverse dot blot hybridization. Seropositivity for C.
trachomatis was evaluated using ELISA for the detection of IgG antibodies. Results: The
total prevalence of HPV infection was 86.3% (113/131). Seropositivity for C. trachomatis
was 26% (34/131). Thirty one women (27.4%; 31/113) tested simultaneously positive for C.
trachomatis and HPV. Of these, 12.9% (4/31) tested negative at histology, while 87.1%
(27/31) tested positive for CIN and invasive carcinomas. The most prevalent HPV type in
the C. trachomatis seropositive women was HPV 16 (51.6%; 16/31) and in these women,
this type was present in 50% (2/4) of cases negative, 33.3% (3/9) of cases CIN1, 53.3%
(8/15) of cases CIN2/CIN3 and 100% (3/3) of cases invasive carcinoma. Taking as reference cases negative for HPV/ C. trachomatis, the positivity for HPV/ C. trachomatis was
significantly associated with CIN 2 or worse diagnostic, especially the types 16 and 18. A
borderline significance was observed when the reference was HPV positive and C. trachomatis negative cases. There was a borderline significance between other types of HPV and
positivity for C. trachomatis with neoplastic diagnosis considering as reference HPV/ C.
trachomatis negative cases. Conclusions: C. trachomatis seropositivity was associated
with severity of cervical neoplasia in women HPV positives. Then, it may be important to
screen for the simultaneous presence of C. trachomatis which may have synergistic pathological effects.