Atypical presentation of herpes simplex virus 2 primary infection: a case report.

BACKGROUND: Cervicitis, an infectious or noninfectious inflammation of the cervix, encompasses a wide range of clinical conditions, from asymptomatic infections to severe lesions, making its diagnosis difficult. Acute cervicitis may develop into pelvic inflammatory disease. In patients with cervicitis, current guidelines recommend testing for herpes simplex virus when external genital lesions are present. Here, we present the case of a patient with an atypical primary herpes simplex virus 2 infection manifesting as cervicitis without genital lesions. CASE PRESENTATION: A 29-year-old Caucasian woman was hospitalized for pelvic inflammatory disease. The patient complained of severe suprapubic pain, fever, and heavy vaginal discharge. The external genitalia were unremarkable, so empirical antibiotic treatment was initiated. Despite 48 hours of well-administered antibiotic therapy, her complaints persisted. Polymerase chain reaction for possible microbial causes was negative for Chlamydia trachomatis and Neisseria gonorrhoeae. There was no bacterial vaginosis. Repeat gynecological examinations with endovaginal ultrasound revealed an enlarged cervix, and pelvic magnetic resonance imaging supported a diagnosis of cervicitis. At this point, additional screening for other sexually transmitted infections and infectious disease-related etiologies of cervicitis was performed, and the polymerase chain reaction analysis of newly isolated samples was positive for herpes simplex virus 2. No antiviral treatment was initiated given the delay in diagnosing herpes simplex virus 2 infection and the slow but spontaneous abatement of symptoms. CONCLUSION: Herpes simplex virus infection should be considered as a possible cause of cervicitis, even in the absence of typical genital lesions. Early detection of herpes simplex virus allows early treatment, helping to reduce the duration and severity of symptoms and therefore potentially reducing recurrences and improving disease control. These data and data from future cases might spur changes in the guidelines on cervicitis testing and treatment.

Infectious Vaginitis, Cervicitis, and Pelvic Inflammatory Disease.

Vaginal symptoms are one of the most common reasons women consult with physicians and can significantly impact quality of life. The differential diagnosis of vaginal discharge includes physiologic discharge, vaginitis, cervicitis, and pelvic inflammatory disease (PID). Vaginitis is inflammation of the vagina, most commonly caused by bacterial vaginosis (BV), vulvovaginal candidiasis, and trichomoniasis infections. Cervicitis is an inflammation of the cervix and typically caused by Chlamydia trachomatis and Neisseria gonorrhoeae. PID is infection of the female upper genital tract, involving the uterus, fallopian tubes, ovaries, and/or pelvic peritoneum and usually caused by Chlamydia trachomatis, Neisseria gonorrhoeae, and bacterial vaginosis-associated pathogens. A pelvic exam should be performed for any woman presenting with vaginal discharge to confirm the diagnosis and rule out an upper tract infection. BV and vulvovaginal candidal infections only require treatment if symptomatic and do not require partner therapy, whereas treatment and partner therapy is recommended for sexually transmitted illnesses, such as trichomoniasis, chlamydia and gonorrhea. Vaginitis may be uncomfortable, but rarely leads to serious long-term consequence, but pelvic inflammatory disease can lead to serious long-term sequelae, including increased risk for ectopic pregnancy, infertility, and chronic pelvic pain.

Histomorphological Evaluation of Non-Neoplastic Lesions of Uterine Cervix and a Correlation of the Lesion with the Clinical Factors.

AIM: This study investigates the prevalence of non-malignant lesions of the cervix among various biopsy samples. METHODS: This case study consists of 50 cases of cervical biopsy over almost two years. The case history and clinical details of the patients were obtained. RESULTS: 60% of the cases that participated in this study reported white discharge per vaginum as a common clinical symptom. 4 cases (8%) showed koilocytic changes specific to the human papillomavirus during the study. Only 2% of the non-specific cervicitis showed lymphoid aggregates. Endocervical changes projected papillary endocervicitis with 9 cases (18%), squamous metaplasia with 7 cases (14%), and nabothian follicle cyst with 3 cases (6%). CONCLUSION: It has been concluded that 50 cases were studied histologically, which had adequate representation of both ecto and endocervical tissue. Moreover, 31-40 years of age of patients showed the highest percentage of non-neoplastic lesions of the cervix when compared to other age groups.

Qualitative and Quantitative Detection of Multiple Sexually Transmitted Infection Pathogens Reveals Distinct Associations with Cervicitis and Vaginitis.

Many diverse pathogens have been discovered from reproductive-tract infections, but the relationship between the presence and abundance of particular pathogen species and disease manifestations is poorly defined. The present work examined the association of multiple common pathogens causing sexually transmitted infections (STIs) with cervicitis and vaginitis. The presence and abundance of 15 STI pathogens and the genotypes of human papillomavirus were determined in a cohort of 944 women that included 159 cervicitis patients, 207 vaginitis patients, and 578 healthy controls. Logistic regression and random forest models were constructed and validated in a separate cohort of 420 women comprising 52 cervicitis patients, 109 vaginitis patients, and 259 healthy controls. The frequency of individual STI pathogen species varied among the symptomatic patients and healthy controls. Abundance determination was necessary for most pathogens that were associated with the studied diseases. STI pathogens were more commonly associated with cervicitis than with vaginitis. Pathogen identification- and quantification-based diagnosis was observed for cervicitis with high sensitivity and specificity, but for vaginitis, the assay results would need to be combined with results of other diagnostic tests to firmly establish the pathogen-disease correlation. Integrated qualitative and quantitative detection of a selected panel of common STI pathogens can reveal their association with cervicitis and vaginitis. STI pathogen identification and quantification can be used to diagnose cervicitis and also help improve correct diagnosis of vaginitis. IMPORTANCE Scarce information exists with regard to whether STI pathogens can be defined as valid microbiological predictive markers for the diagnosis of cervicitis and vaginitis. We therefore conducted this study to assess the presence and abundance of a wide range of STI pathogens among patients having these two diseases and healthy controls as well. High sensitivity and specificity were observed for cervicitis by pathogen identification- and quantification-based diagnosis. In contrast, the assay results obtained for vaginitis would need to be combined with test results obtained by other diagnostic methods to decisively establish the pathogen-disease correlation. Simultaneous qualitative and quantitative detection of a selected panel of common STI pathogens and further coupling with machine learning models is worthwhile for establishing pathogen-based diagnosis of gynecological inflammations, which could be of great value in guiding the rational use of antimicrobials to control the spread of STIs.

[Necrotic cervicitis for co-infection of herpes simplex virus 2 and Mycoplasma genitalium]. / Cervicitis necrótica por co-infección de virus herpes simplex 2 y Mycoplasma genitalium.

Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.

A micro-Raman spectroscopy study of inflammatory condition of human cervix: Probing of tissues and blood plasma samples.

The present study explores the application of the micro-Raman spectroscopy technique to discriminate normal and cervicitis condition from cervical malignancy by analyzing the Raman signatures of tissues and plasma samples of the same subjects. The Raman peaks from tissue samples at 1026 cm-1,1298 cm-1 and 1243 cm-1 are attributed to glycogen, fatty acids and collagen and are found to be reliable signatures capable of identifying cervicitis and normal condition from cervical cancer. The Raman signatures from plasma samples belonging to carbohydrates (578 cm-1), lipids (1059 cm-1) and nucleic acids (1077 cm-1,1341 cm-1 and 1357 cm-1) are quite useful to classify various pathological conditions of cervix at par with tissue based diagnosis. The PCA-SVM based classification of the spectral data indicates the potential of Raman spectroscopy based liquid biopsy to rule out false diagnosis of cervicitis as cervical malignancy.

Analysis of Serum Levels of IFN-γ, IL-4, and TNF-α in Patients with Cervicitis Complicated by HPV Infection and Their Clinical Significance.

In order to investigate the expression levels of serum IFN-γ, IL-4, and tumor necrosis TNF-α in patients with cervicitis complicated with human papillomavirus (HPV) infection and clinical significance, a retrospective study was conducted on 90 patients with chronic cervicitis complicated by HP V infection who visited our hospital from June 2020 to June 2021, and they are included in the research group. According to the degree of HPV infection, the patients are divided into low-risk HPV type group (n = 65 cases) and high-risk HPV type group (n = 25 cases); 50 patients with cervicitis (without HPV infection) who received treatment in our hospital are selected as control group 1. Fifty healthy women who underwent physical examination are selected as the control group 2. The general data of the two groups of patients during hospitalization are collected, and HPV-DNA, IFN-γ, IL-4, and TNF-α are detected in all patients. For patients with cervicitis complicated by HPV infection, the IFN-indexes in the body are significantly decreased, IL-4 and TNF-αare significantly increased, and with the degree of HPV infection, IFN-γ, IL-4, and TNF-α have high diagnostic performance with HPV infection, and there is a significant correlation between the three, which can be used in cervicitis complicated with HPV infection. It is widely used in the early diagnosis and screening of infected patients.

Cervicitis necrótica por co-infección de virus herpes simplex 2 y Mycoplasma genitalium / Necrotic cervicitis for co-infection of herpes simplex virus 2 and Mycoplasma genitalium

Resumen Las cervicitis es una condición frecuente causada principalmente por agentes de transmisión sexual. Su presentación clínica varía desde cuadros asintomáticos hasta procesos inflamatorios extensos, que incluso asemejan un tumor maligno. Presentamos el caso de una adolescente que presentó úlceras genitales, síntomas generales y cérvix necrótico con aspecto tumoral. Los estudios de laboratorio confirmaron una co-infección por virus herpes simplex 2 (HSV-2) y Mycoplasma genitalium. El estudio histológico descartó una neo- plasia. Evolucionó favorablemente al tratamiento antimicrobiano, con recuperación progresiva del aspecto del cérvix. La cervicitis en raras ocasiones se presenta con compromiso necrótico. La co-infección por HSV-2 y M. genitalium, en este caso, pudo ser el determinante del daño cervical y la necrosis. Una evaluación acuciosa y estudio con exámenes diagnósticos de alta sensibilidad y especificidad permitieron hacer un diagnóstico y tratamiento adecuado.

Abstract Cervicitis is a frequent condition caused mainly by sexually trans- mitted agents. The clinical spectrum varies from absence of symptoms to extensive inflammatory processes that may simulate a malignant neoplasm. We present a clinical case of an adolescent with genital ulcers and systemic disease. Speculoscopy revealed a tumoral-looking cervix. Laboratory studies confirm infection with herpes simplex virus 2 (HSV-2) and Mycoplasma genitalium, together with a histological study that ruled out neoplasia. It progresses favorably to antimicrobial treatment, with recovery of the appearance of the cervix. Cervicitis rarely presents with necrotic involvement. Co-infection with HSV-2 and M. genitalium infection may have been the determinant of cervical damage and the necrotic appearance. A thorough evaluation and study with highly sensitive and specific diagnostic tests allowed an adequate diagnosis and treatment.

Diagnostic value of the QuickStripe™ chlamydia rapid test among high-risk women in Jakarta.

BACKGROUND: Difficulty in diagnosing Chlamydia trachomatis infections, including chlamydial cervicitis, is a notable challenge in managing sexually transmitted infections in Indonesia. Gram staining is usually done to make a presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered the gold standard, but it is costly, technically demanding, and difficult to be performed in low-resource settings. Thus, rapid point-of-care tests with high sensitivity and specificity are needed to diagnose chlamydial cervicitis. METHODS: This cross-sectional study included symptomatic and asymptomatic high-risk women in the Mulya Jaya Sex Workers Rehabilitation Center in June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ chlamydia rapid test (CRT), Gram staining, and real-time PCR. RESULTS: A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48.80%-90.85%) and 81.82% (95% CI: 59.72%-94.81%). Positive and negative predictive values were 77.78% (95% CI: 58.09%-89.84%) and 78.05% (95% CI: 62.39%-89.44%). Proportion of chlamydial cervicitis in study participants based on real-time PCR was 46.3%. CONCLUSIONS: We concluded that QuickStripe™ CRT can be recommended as an alternative diagnostic test for high-risk populations in Jakarta.

Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis.

Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis. Associated factors to cervicitis: sexually active women younger than 25 years old, new or multiple sexual partners, partners with STI, previous history or presence of other STI, and irregular use of condoms.

[Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis]. / Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite.

Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.

As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.

Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.

Brazilian protocol for sexually transmitted infections, 2020: infections that cause cervicitis

Abstract Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.

Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.

Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam cervicite / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause cervicitis / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan cervicitis

Resumo As infecções que causam cervicite são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos das infecções que causam cervicite, bem como recomendações sobre a triagem, diagnóstico e tratamento das pessoas acometidas e suas parcerias sexuais. Além disso, discutem-se estratégias para as ações de vigilância, prevenção e controle desses agravos para os profissionais de saúde e gestores envolvidos no manejo programático e operacional das infecções sexualmente transmissíveis. A ampliação do acesso aos testes para diagnóstico e o tratamento precoce são cruciais para o controle da disseminação dos patógenos causadores de cervicite.

Abstract Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis, as well as recommendations on screening, diagnosis and treatment of affected people and their sexual partnerships. In addition, it discusses strategies for surveillance, prevention and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cevicitis.

Resumen Las infecciones que causan cervicitis son uno de los temas que integran el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con expertos. Este artículo presenta aspectos epidemiológicos y clínicos de las infecciones que causan cervicitis, así como recomendaciones sobre el cribado, diagnóstico y tratamiento de las personas afectadas y sus parejas sexuales. Además, se discuten estrategias de vigilancia, prevención y control de estas enfermedades para los profesionales y gestores de salud involucrados en el manejo programático y operativo de las infecciones de transmisión sexual. Ampliar el acceso a las pruebas de diagnóstico y a un tratamiento precoz es crucial para controlar la propagación de los agentes patógenos que causan cervicitis.

[Clinical Value of Peripheral Blood Circulating Tumor Cells Detection in Early Cervical Infiltrating Carcinoma Screening].

OBJECTIVE: To observe the difference of circulating tumor cells (CTC) in peripheral blood of patients with different degrees of cervical lesions, and to evaluate the effectiveness of CTC detection in screening early invasive cervical cancer. METHODS: From December 2015 to October 2017, 63 cases of cervicitis, low-grade and high-grade intraepithelial lesions (LSIL, HSIL) and early invasive cervical cancer were confirmed by histopathological and clinical stages in Zhongshan Boai Hospital and Zhongshan Hospital Affiliated to Zhongshan University. The immunomagnetic bead negative enrichment technique combined with immunofluorescence was used. In situ hybridization (imFISH) was used to detect CTC in peripheral blood of patients. The positive rate and quantity of CTC in four groups were analyzed. The diagnostic efficacy of CTC in early invasive cervical cancer was evaluated based on the results of histopathological diagnosis and clinical staging. RESULTS: ①The positive rates of CTC in cervicitis group, LSIL group, HSIL group and early invasive cervical cancer group were 0, 0, 19.05% and 84.13% respectively. The overall difference was statistically significant ( χ 2=504.00， P<0.05). The positive rate of CTC in early invasive cervical cancer group was higher than that in other groups ( P<0.008 3). The positive rates of CTC in HSIL group were significantly different from those in LSIL group and cervicitis group ( P<0.008 3). ②The average number (median) of CTC positive in cervicitis group, LSIL group, HSIL group and early invasive cervical cancer group was 0, 0, 1/4 mL, 3/4 mL, respectively. The average number of positive CTC in early invasive cervical cancer group was higher than that in other groups, and the difference was significant compared with other groups ( P<0.008 3). The average number of CTC positive in HSIL group was significantly different from that in LSIL and cervicitis group ( P<0.008 3). ③The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of CTC positive results in the diagnosis of early invasive cervical cancer were 84.13%, 93.65%, 91.27%, 81.54% and 94.65%, respectively. CONCLUSION: CTC exists in patients with HSIL and early invasive cervical cancer. With the aggravation of cervical lesions, the positive rate and number of CTC test results increase. CTC detection in early invasive cervical cancer screening has a certain practical value in clinic.

Association of TLR4 and TLR9 gene polymorphisms and haplotypes with cervicitis susceptibility.

BACKGROUND: Cervicitis is one of the major health problems amongst women caused by infection of various pathogens including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) as well as human papillomavirus (HPV), and persistent cervical inflammation is one of the etiologic agents of cervical cancer. Toll-like receptors (TLRs) play an important role in the recognition and subsequent elimination of these pathogens. Variations in the Toll-like receptor genes influence susceptibility to pathogens as well as disease progression independently. METHODS: Ten single nucleotide polymorphisms, five each of TLR4 and TLR9 genes were analyzed among 130 cervicitis patients and 150 controls either using polymerase chain reaction-restriction fragment length polymorphism or allele specific-PCR. RESULTS: T. vaginalis infection was found at the highest frequency (30.7%) as compared to C. trachomatis (1.5%), N. gonorrhoeae (2.3%) and HPV (4.6%) infections in cervicitis patients. TLR4 rs11536889 CC (age-adjusted OR, 2.469 [95% CI, 1.499 to 4.065]; p < 0.001) and TLR9 rs187084 TC (age-adjusted OR, 2.165 [95% CI, 1.267-3.699]; p = 0.005) genotypes showed the higher distribution in cervicitis patients compared to controls. In addition, TLR4 rs11536889 C allele was shown to increase the risk of cervicitis (age-adjusted OR, 1.632 [95% CI, 1.132 to 2.352]; p = 0.009) compared to controls. The TLR4 haplotype GCA (OR, 0.6 [95% CI, 0.38-0.95]; p = 0.0272) and TLR9 haplotype GTA (OR, 1.99 [95% CI, 1.14-3.48]; p = 0.014) were found to be associated with decreased and increased risk of cervicitis respectively. CONCLUSIONS: TLR4 and TLR9 polymorphisms, as well as haplotypes were shown to modulate the cervicitis risk.

The performance of a syndromic algorithm in diagnosing cervicitis in Jamaica.

A cross-sectional survey of 295 persons attending a major sexually transmitted infection clinic in Jamaica's capital city showed that the Ministry of Health's syndromic algorithm has moderate sensitivity and negative predictive value for diagnosing cervicitis. In the absence of diagnostic tests for sexually transmitted infections, a syndromic algorithm continues to be useful for diagnosing sexually transmitted infections.

Comparison of Chlorquinaldol-Promestriene Vaginal Tablets and Opin Suppositories Effect on Inflammatory Factors and Immune Function in Chronic HPV Cervicitis.

OBJECTIVE: To compare the effects of chlorquinaldol-promestriene vaginal tablets and opin suppositories on serum inflammatory factors and immune function in patients with chronic cervicitis complicated with HPV infection. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: Department of Gynaecology and Obstetrics, People's Hospital of Zhouzhi County, Shaanxi, China, from January 2016 to June 2017. METHODOLOGY: A total of 98 patients with chronic cervicitis complicated with HPV infection were randomly divided into the observation group and the control group with 49 cases in each group. Control group received vaginal administration of opin suppositories, and the observation group received chlorquinaldol-promestriene vaginal tablets. After treatment, the HPV-DNA negative conversion rate, levels of serum inflammatory factors (IL-1, IL-6 and hs-CRP) and indices of immune function (CD3 +,CD4 +, CD8 + and CD4 +/CD8 +) were compared between the two groups. RESULTS: At 6 and 9 months after treatment, the HPV-DNA negative conversion rate in the observation group was higher than that in the control group (p=0.001 and p<0.001, respectively). At 6 months after treatment, serum IL-1, IL-6, and hs-CRP levels in the observation group were lower than those in the control group (p<0.001, p=0.001 and p=0.002, respectively); serum CD3 +,CD4 +, CD8 + and CD4 +/CD8 + levels in the observation group were higher than those in the control group (all p<0.001). CONCLUSION: Chlorquinaldol-promestriene vaginal tablet is more effective than opin suppository in the treatment of patients with chronic cervicitis complicated with HPV infection. It can effectively improve the HPV-DNA negative conversion rate, reduce the level of serum inflammatory factors and improve the body's immune function.