ABSTRACT
OBJECTIVES: Chlamydia trachomatis infection in the cervix and uterus has been hypothesised to be a co-factor for cervical cancer. We performed a cross sectional study in Bogota, Colombia, where cervical cancer rates are high, to determine the prevalence and determinants of C trachomatis infection, and in particular its association with human papillomavirus (HPV). METHODS: 1829 low income sexually active women were interviewed and tested for C trachomatis, using an endogenous plasmid PCR-EIA, and for 37 HPV types, using a general primer GP5+/6+ mediated PCR-EIA. RESULTS: The overall prevalence of C trachomatis was 5.0%, and it did not differ substantially between women with normal (5.0%) and those with abnormal (5.2%) cervical cytology. Women infected with any HPV type (15.1%) had a slightly increased risk of being simultaneously infected with C trachomatis (adjusted OR 1.3, 95% CI: 0.8 to 2.4). This association was stronger when multiple HPV infections (adjusted OR 2.5, 95% CI: 1.1 to 5.9) were present. No other lifestyle or reproductive characteristics were clearly associated with risk of C trachomatis infection. CONCLUSIONS: HPV infected women, particularly women with multiple HPV infections, are at increased risk of being infected with C trachomatis.
Subject(s)
Chlamydia Infections/epidemiology , Chlamydia trachomatis , Adult , Aged , Chlamydia Infections/complications , Cohort Studies , Colombia/epidemiology , Cross-Sectional Studies , Female , Humans , Middle Aged , Papillomaviridae , Papillomavirus Infections/complications , Papillomavirus Infections/epidemiology , Polymerase Chain Reaction/methods , Prevalence , Prospective Studies , Risk Factors , Tumor Virus Infections/complications , Tumor Virus Infections/epidemiology , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/virology , Vaginal SmearsABSTRACT
Low grade squamous intra-epithelial lesions could be considered as a manifestation of human papillomavirus exposition, however the discrepancy between rates of infection with human papillomavirus and development of low grade squamous intra-epithelial lesions is notable. Here we report a cross-sectional three-armed case-control study in the Colombian population, to compare the risk factors of women with low grade squamous intra-epithelial lesions with that of human papillomavirus DNA-negative and positive women with normal cytology.
Subject(s)
Papillomaviridae/isolation & purification , Papillomavirus Infections/virology , Tumor Virus Infections/virology , Uterine Cervical Dysplasia/virology , Uterine Cervical Neoplasms/virology , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Chlamydia trachomatis/genetics , Chlamydia trachomatis/isolation & purification , Colombia/epidemiology , Cross-Sectional Studies , DNA Probes, HPV , DNA, Bacterial/analysis , DNA, Viral/analysis , Female , Humans , Middle Aged , Papillomaviridae/genetics , Papillomavirus Infections/epidemiology , Papillomavirus Infections/pathology , Polymerase Chain Reaction , Risk Factors , Tumor Virus Infections/epidemiology , Tumor Virus Infections/pathology , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/pathology , Vaginal Smears/methods , Uterine Cervical Dysplasia/epidemiology , Uterine Cervical Dysplasia/pathologyABSTRACT
Human papillomavirus is the principal risk factor associated with cervical cancer, the most common malignancy among women in Colombia. We conducted a survey, aiming to report type specific prevalence and determinants of human papillomavirus infection in women with normal cytology. A total of 1859 women from Bogota, Colombia were interviewed and tested for human papillomavirus using a general primer GP5+/GP6+ mediated PCR-EIA. The overall HPV DNA prevalence was 14.8%; 9% of the women were infected by high risk types, 3.1% by low risk types, 2.3% by both high risk/low risk types and 0.4% by uncharacterized types (human papillomavirus X). Thirty-two different human papillomavirus types were detected, being human papillomavirus 16, 58, 56, 81(CP8304) and 18 the most common types. The human papillomavirus prevalence was 26.1% among women younger than 20 years, 2.3% in women aged 45-54 years, and 13.2% in women aged 55 years or more. For low risk types the highest peak of prevalence was observed in women aged 55 years or more. Compared to women aged 35-44 years, women aged less than 20 years had a 10-fold increased risk of having multiple infections. Besides age, there was a positive association between the risk of human papillomavirus infection and number of regular sexual partners and oral contraceptive use. In women aged below 25 years, high educational level and having had casual sexual partners predicted infection risk. In conclusion, there was a broad diversity of human papillomavirus infections with high risk types being the most common types detected. In this population multiplicity of sexual partners and, among young women, high educational level and casual sexual partners seem to determine risk.