背景:梅毒和人乳头瘤病毒(HPV)是影响同一风险组女性的性传播感染。因此,本研究的主要目的是调查有梅毒和无梅毒女性人群中HPV的患病率,并观察合并感染时HPV宫颈病变的特点.还评估了与合并感染相关的社会人口统计学因素。
方法:本病例对照研究在巴西的HIV/STD检测和培训中心进行。研究组由患有梅毒(病例)和无梅毒(对照)的妇女组成,按年龄配对。HPV的存在,HPV亚型,和病变的严重程度进行了调查。所有女性都接受了社会人口统计采访,临床数据收集,细胞病理学分析的细胞收集,和用于HPV诊断的混合捕获测试。采用卡方检验进行统计分析。
结果:样本包括176名女性,每组88人。病例中HPV的患病率为14.8%(n=13),对照组为18.1%(n=16),它们之间没有统计学上的显著差异。文盲个体在对照组中更为普遍(p=0.023)。考虑到女性有性传播感染的暗示性迹象,30%(6)的患者和对照组有高危型HPV,15%(3)合并感染。细胞病理学评估显示,两组之间在细胞异型性方面没有差异。然而,ASC-US和ASC-H(不确定意义和高级别的非典型鳞状细胞)仅在合并感染的女性中发现,这些患者中有75%的高危型HPV检测呈阳性。考虑到宫颈病变的分布,在高危型HPV患者中评估HSIL(高度上皮内病变),案件和控制。
结论:感染梅毒的患者HPV的患病率没有增加。此外,合并感染似乎不是宫颈癌前兆病变的加重因素。
BACKGROUND: Syphilis and human papillomavirus (HPV) are sexually transmitted infections affecting women in the same risk group. Thus, the main objective of the present study was to investigate the prevalence of HPV in a population of women with and without syphilis and observe the characteristics of HPV cervical lesions when coinfection occurs. Sociodemographic factors associated with
coinfection were also evaluated.
METHODS: This
case-control study was conducted at a Brazilian HIV/STD testing and training center. Study groups were composed of women with (
case) and without syphilis (control), paired by age. The presence of HPV, HPV subtype, and lesion severity were investigated. All women were subjected to a sociodemographic interview, clinical data collection, cell collection for cytopathological analysis, and a hybrid capture test for HPV diagnosis. The chi-square test was used for statistical analysis.
RESULTS: The sample consisted of 176 women, 88 in each group. The prevalence of HPV was 14.8 % in the
case (n = 13) and 18.1 % in the control group (n = 16), and there was no statistically significant difference between them. Illiterate individuals were more prevalent in the control group (p = 0.023). Considering women with suggestive signs of STIs, 30 % (6) of the patients and controls had high-risk HPV, and 15 % (3) had coinfection. The cytopathological assessment showed no differences between the groups concerning cellular atypia. However, ASC-US and ASC-H (atypical squamous cells of undetermined significance and high-grade) were only found in women with coinfections, with 75 % of these patients testing positive for high-risk HPV. Considering the distribution of lesions on the cervix, the HSIL (high-grade intraepithelial lesion) was assessed in high-risk HPV patients, both cases and controls.
CONCLUSIONS: The prevalence of HPV was not increased in patients infected with syphilis. In addition,
coinfection does not seem to be an aggravating factor for the presence of precursor lesions of cervical cancer.