Sexually Transmitted Infections Detected by Multiplex Real Time PCR in Asymptomatic Women and Association with Cervical Intraepithelial Neoplasia

Objective To determine the frequency of sexually transmitted infections (STIs) in asymptomatic women and the association of STIs with cervical intraepithelial neoplasia (CIN). Methods A cross-sectional study was performed, enrolling women examined in a general gynecology clinic and in a colposcopy referral center from October 2014 to October 2015. The colposcopy group consisted of 71 women, and the general gynecology group consisted of 55 women. Cervical samples were collected for cervical cytology and a multiplex real-time polymerase chain reaction (PCR) was developed to detect human papillomavirus (HPV) and the STIs caused by the following microorganisms: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, and Neisseria gonorrhoeae. A multivariate analysis was performed by logistic regression, considering the significance level of 0.05. Results The general frequency of STIs was: 46.8% (HPV); 27.8% (C. trachomatis); 28.6% (M. genitalium); 0.8% (M. hominis); 4.8% (U. urealyticum); and 4.8% (N. gonorrhoeae). The significant risk factors for CIN were: HPV infection (odds ratio [OR] = 2.53; p = 0.024); C. trachomatis (OR = 3.04; p = 0.009); M. genitalium (OR = 2.37; p = 0.04); and HPV and C. trachomatis coinfection (OR = 3.11; p = 0.023). After the multivariate analysis, a significant association was found between HPV and CIN (OR = 2.48; 95% confidence interval [95%CI]: 1.04–5.92; p = 0.04); and between C. trachomatis and CIN (OR = 2.69; 95%CI: 1.11–6.53; p = 0.028). Conclusion The frequency of STIs was high in asymptomatic patients. Infections by HPV and C. trachomatis were independently associated with the presence of CIN. The high frequency of STIs in asymptomatic women suggests the need for routine screening of these infections.

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Human papillomavirus infection and associated factors for cervical intraepithelial neoplasia in women living with HIV in China: a cross-sectional study

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053636 ◽

2018 ◽

Vol 95 (2) ◽

pp. 140-144 ◽

Cited By ~ 1

Author(s):

Qian Wang ◽

Xiaomeng Ma ◽

Xiaosong Zhang ◽

Jason J Ong ◽

Jun Jing ◽

...

Keyword(s):

Logistic Regression ◽

Human Papillomavirus ◽

Cervical Intraepithelial Neoplasia ◽

Sexually Transmitted Infections ◽

Associated Factors ◽

Intraepithelial Neoplasia ◽

Multivariate Logistic Regression ◽

Sexually Transmitted ◽

Women Living With Hiv ◽

Living With Hiv

ObjectiveWomen living with HIV (WLHIV) face disproportionately higher risks of acquiring human papillomavirus (HPV) compared with HIV negative counterparts. We aimed to investigate the prevalence of HPV in WLHIV in Chinese hospital setting and identify associated factors to the progression of late-stage cervical intraepithelial neoplasia (CIN2+) in this population.MethodThis retrospective study collected data from 183 WLHIV on antiretroviral treatment (ART), based on reproductive health questionnaires. Gynaecological examination results including serum (for HIV viral load, CD4 T-cell count, hepatitis B infections, syphilis) and vaginal swabs for common bacterial sexually transmitted infections (STIs). Multivariate-logistic regression was applied to analyze the contributing factors to CIN2+.ResultsHIV coinfection with other Sexually Transmitted Infections (STIs) were observed in 99 participants (54.1%, (99/183)). HPV (43.7% (80/183)) was the most prevalent STI. The three most prevalent HPV subtypes were all high-risk HPV (HR-HPV), including HPV52 (33.8% (27/80)), HPV58 (21.3% (17/80)) and HPV33 (13.75% (11/80)). About a third (37.5%, 30/80) of women with HPV had HR-HPV. Multiple HPV coinfections were common in HIV-HPV coinfected women (41.3%, 33/80). Cytological examinations revealed that 77.5% (62/80) HPV+ women had detectable cervical lesions. In comparison, only 4.9% (5/103) HPV negative womenwith Atypia and 1.0% (1/103) with CIN1 were diagnosed. Multivariate logistic regression revealed that HPV16 (OR=19.04, 2.53 to 122.92; p=0.004) and HPV18 (OR=11.54, 1.45 to 91.64; p=0.021) infections were significantly associated with CIN2+ in HIV-HPV coinfected women.ConclusionA high prevalence of HPV was found in women on ART. HPV16/18 infection are strong associated factors to CIN2+ in HIV-HPV coinfected women.

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The Impact of MTHFR 1298 A > C and 677 C > T Gene Polymorphisms as Susceptibility Risk Factors in Cervical Intraepithelial Neoplasia Related to HPV and Sexually Transmitted Infections

The Journal of Obstetrics and Gynecology of India ◽

10.1007/s13224-020-01363-z ◽

2020 ◽

Vol 70 (6) ◽

pp. 503-509

Author(s):

Amir Sohrabi ◽

Fatemeh Bassam-Tolami ◽

Mohsen Imani

Keyword(s):

Risk Factors ◽

Cervical Intraepithelial Neoplasia ◽

Sexually Transmitted Infections ◽

Cancer Progression ◽

Potential Risk ◽

Intraepithelial Neoplasia ◽

Sexually Transmitted ◽

Significant Difference ◽

Hpv Genotypes ◽

The Impact

Abstract Background HPV genotypes are the most common etiological factor for genital neoplasia. It would appear that sexually transmitted infections accompanied with HPV genotypes might have synergistic interactions in cancer progression. The genetic polymorphisms are involved in metabolizing carcinogens which may contribute to the susceptibility of developing genital cancers by less efficient or overly down metabolic pathways and cell signaling. MTHFR polymorphisms are related to several metabolic disorders and human cancers. We investigated the contribution of MTHFR 1298 and MTHFR 677 polymorphisms as potential risk factors for outcomes with HPV genotypes and STIs in Iranian population. Materials and Methods As a case–control study, MTHFR A1298C and C677T were assessed for SNPs analysis using a PCR–RFLP assay in 50 cervical intraepithelial neoplasia (CIN) cases, 98 HPV-positive subjects and 47 non-cancerous/non-HPV patients as healthy controls. Results Finding suggested a significant association between the MTHFR 1298 CC polymorphisms (OR = 3.5, 95% CI = 1.13–10.82, P ≤ 0.05) in women with CIN as compared to non-cancerous/non-HPV subjects. There was not a significant difference of MTHFR 677 between outcomes. Discussion It would seem MTHFR 1298 CC is more likely to be a potential risk factor for HPV–cervical cancer progression. Consequences support further attempts to understand the clinical manifestations of neoplasia related to genital infections and gene mutations.

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Bacterial etiology of sexually transmitted infections at a STI clinic in Ghana; use of multiplex real time PCR

Ghana Medical Journal ◽

10.4314/gmj.v50i3.5 ◽

2016 ◽

Vol 50 (3) ◽

pp. 142-148

Author(s):

Augustina A Sylverken ◽

Ellis Owusu-Dabo ◽

Denis D Yar ◽

Samson P Salifu ◽

Nana Yaa Awua-Boateng ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Real Time ◽

Real Time Pcr ◽

Pathogen Detection ◽

Clinical Manifestations ◽

Diagnostic Tools ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Asymptomatic Patients ◽

Syndromic Approach

Background: Most sexually transmitted infection (STI) management efforts focus on the syndromic approach to diagnose and treat patients. However, most women with STIs have been shown to be entirely asymptomatic, or if symptoms exist, are often missed when either clinical or conventional bacteriologic diagnostic tools are employed.Methods: We assessed the performance of a multiplex real time PCR assay to describe other potential pathogens that could be missed by conventional bacteriological techniques in 200 women attending a routine STI clinic in Kumasi, Ghana.Results: Although a total 78.00% of the women were asymptomatic, 77.1% of them tested positive for at least one bacterial STI pathogen. Mycoplasma genitalium was the most commonly detectable pathogen present in 67.5% of all women. Of those testing positive, 25.0% had single infections, while 38.0% and 19.5% had double and triple infections respectively. Altogether, 86.54% and 90.91% of the symptomatic and asymptomatic women respectively tested positive for at least one pathogen (p<0.05). There were no significant associations (p<0.05) between the clinical manifestations of the symptomatic women and the pathogens detected in their samples.Conclusions: Our study confirmed the importance of complementing the syndromic approach to STI management with pathogen detection and most importantly recognise that STIs in women are asymptomatic and regular empirical testing even for both symptomatic and asymptomatic patients is critical for complete clinical treatment.Funding: EOD (Ellis Owusu-Dabo Research working group, KCCR)Keywords: Etiology, Syndromic, Sexually Transmitted Infections, Multiplex real time PCR

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Faculty Opinions recommendation of Usefulness of a novel multiplex real-time PCR assay for the diagnosis of sexually-transmitted infections.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726041737.793554298 ◽

2018 ◽

Author(s):

Seung-Ju Lee

Keyword(s):

Sexually Transmitted Infections ◽

Real Time ◽

Real Time Pcr ◽

Pcr Assay ◽

Sexually Transmitted

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Mass spectrometry and multivariate analysis to classify cervical intraepithelial neoplasia from blood plasma: an untargeted lipidomic study

Scientific Reports ◽

10.1038/s41598-018-22317-6 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 4

Author(s):

Ana C. O. Neves ◽

Camilo L. M. Morais ◽

Thais P. P. Mendes ◽

Boniek G. Vaz ◽

Kássio M. G. Lima

Keyword(s):

Mass Spectrometry ◽

Multivariate Analysis ◽

Blood Plasma ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia

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Molecular Diagnosis of Sexually Transmitted Infections (STI) in Symptomatic Women of Puducherry by a Commercial Real Time Multiplex PCR, FTD Urethritis Plus - A Preliminary Report

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.13.3.55 ◽

2019 ◽

Vol 13 (3) ◽

pp. 1791-1796

Author(s):

Selvaraj Stephen ◽

Jothimani Pradeep ◽

Chinnadurai Rajkumar ◽

Rupal Samal ◽

Ashwini Vishalakshi ◽

...

Keyword(s):

Multiplex Pcr ◽

Sexually Transmitted Infections ◽

Real Time ◽

Molecular Diagnosis ◽

Preliminary Report ◽

Sexually Transmitted

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Real time quantitative methylation detection of PAX1 gene in cervical cancer screening

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-001144 ◽

2020 ◽

Vol 30 (10) ◽

pp. 1488-1492

Author(s):

Haifeng Liu ◽

Xia Meng ◽

Jingyi Wang

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Intraepithelial Neoplasia ◽

Real Time ◽

Cervical Cancer Screening ◽

Invasive Cervical Cancer ◽

Intraepithelial Neoplasia ◽

Cancer Group ◽

Polymerase Chain ◽

Folic Acid Receptor

IntroductionDNA methylation is currently found to be associated with the progression of cervical intraepithelial neoplasia and the development of cervical cancer. The aim of this study was to analyze the role of real time quantitative methylation detection of the PAX1 gene in cervical cancer screening.MethodsAll eligible patients who underwent multiple detections for cervical cancer were assigned to the normal cervical group (n=21), cervical intraepithelial neoplasia I group (n=7), cervical intraepithelial neoplasia II+III group (n=12), or invasive cervical cancer group (n=14) based on pathological gradings. The methylation level of the PAX1 gene was detected using the real time quantitative methylation specific polymerase chain reaction assay and assessed by △Cp value. The diagnostic performance of PAX1 methylation detection was compared with folic acid receptor mediated diagnosis, the Thinprep cytology test, and human papilloma virus (HPV) testing.ResultsThe △Cp value in the invasive cervical cancer group was (6.15±4.07), significantly lower than that in the other groups (F=26.45, p<0.001). The area under the curve (AUC) of PAX1 methylation detection was 0.902 (95% confidence interval (CI) 0.817–0.986; p<0.001), and sensitivity and specificity were 92.30% and 78.60% when the cut-off value of △Cp was 13.28. The AUC of PAX1 methylation detection was notably larger compared with 0.709 for folic acid receptor mediated diagnosis (95% CI 0.568–0.849, p=0.009), 0.702 for the Thinprep cytology test (95% CI 0.559–0.844, p=0.015), and 0.655 for HPV testing (95% CI 0.508–0.802, p=0.014).ConclusionThrough quantitative methylation specific polymerase chain reaction assay characterized by rapid screening and simple operation, the methylation detection of the PAX1 gene exhibited a higher diagnostic performance and may be a promising method for cervical cancer screening.

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