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. 2020 Jun;27(6):1587-1595.
doi: 10.1016/j.sjbs.2020.03.021. Epub 2020 Mar 19.

Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia

H J Alotaibi  1 , F N Almajhdi  1 , A N Alsaleh  1 , D A Obeid  2 , H H Khayat  2 , T A Al-Muammer  3 , A M Tulbah  4 , M B Alfageeh  5 , M N Al-Ahdal  2   6 , F S Alhamlan  2   6
Affiliations

Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia

H J Alotaibi et al. Saudi J Biol Sci. 2020 Jun.

Abstract

Human papillomavirus (HPV) is a causative agent of cervical and other cancers. Sexually transmitted Infections (STIs) may play a crucial role in HPV persistence, leading to serious complications, including cervical cancer. This study investigated the association of HPV/STI co-infection in cervical samples with cervical dysplasia among women in Saudi Arabia. HPV-positive cervical samples (n = 142) were obtained from previous studies and newly collected samples (n = 209) were obtained from women aged 19-83 years. For HPV detection and genotyping, PCR and Genoflow HPV assay kits were used. STIs were detected using a Genoflow STD array kit. Of 351 samples, 94 (27%) were positive for STIs. Among HPV-positive samples, 36 (25%) were positive for STIs; the most common pathogens were Ureaplasma urealyticum/Ureaplasma parvu (13%) and Mycoplasma hominis (6%). A global significant correlation was detected between HPV and STIs with progression of abnormal cervical cytology (χ2 = 176, P < 0.0001). Associations between cervical cytology diagnosis and HPV status, STI types (opportunistic and pathogenic), and the presence of Ureaplasma spp., and Mycoplasma hominis were significant (P < 0.05). Our results suggest that additional study in a larger population is warranted to determine the association between HPV/STI co-infection and cervical neoplasia in Saudi women.

Keywords: Cervical cancer; HPV; Sexually transmitted disease; Sexually transmitted infection; Women’s health.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Distribution of sexually transmitted infections (STIs) by HPV status. The STIs were detected by the DiagCor GenoFlow sexually transmitted disease panel. The kit detects 11 types of STI pathogens, including HPV-6, HPV-11, TV, CT, NG, UU, UP, MG, MH, HSV-1, and HSV-2. The highest detected organism is UU/UP, followed by MG, and HPV 6 and 11.
Fig. 2
Fig. 2
Distribution of cases by cervical cytology grade and the presence of sexually transmitted infection (STI). Most of the cases are normal, while 20.5% have a normal cytology grade and are positive for an STI. Of the cervical cancer cases, 12.5% have no STI, and 3.1% are positive for an STI.
Fig. 3
Fig. 3
(A) Distribution of age by HPV status and cytology grade. Women who are positive for HPV and have abnormal cytology grades are older than the other women. (B) Distribution of age by sexually transmitted infection (STI) status and cytology grade. Women with ASCUS or HGSIL who are positive for STIs are younger. For LGSIL and cervical cancer, most of the women who are positive for STIs are older than those in the group negative for STIs.
See this image and copyright information in PMC

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Further Reading

    1. Alhamlan F.S., Khayat H.H., Ramisetty-Mikler S., Al-Muammar T.A., Tulbah A.M., Al-Badawi I.A., Kurdi W.I., Tulbah M.I., Alkhenizan A.A., Hussain A.N., Ahmed M., Al-Ahdal M.N. Sociodemographic characteristics and sexual behavior as risk factors for human papillomavirus infection in Saudi Arabia. Int. J. Infect. Dis. 2016;46:94–99. doi: 10.1016/j.ijid.2016.04.004. - DOI - PubMed
    1. AlObaid A., Al-Badawi I., Al-Kadri H., Gopala K., Kandeil W., Quint W., Al-Aker M., DeAntonio R. Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infect. Dis. 2014;14:643. doi: 10.1186/s12879-014-0643-8. - DOI - PMC - PubMed