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CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(09): 540-546
DOI: 10.1055/s-0038-1669994
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Infecções sexualmente transmissíveis detectadas por PCR multiplex em tempo real em mulheres assintomáticas e associação com neoplasia intraepitelial cervical
Luiza de Miranda Lima
1   Instituto de Educação e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil
,
Carolina René Hoelzle
1   Instituto de Educação e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil
,
Renata Toscano Simões
1   Instituto de Educação e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil
,
Maria Inês de Miranda Lima
1   Instituto de Educação e Pesquisa da Santa Casa, Belo Horizonte, MG, Brazil
,
Jordana Rodrigues Barbosa Fradico
2   Research and Development Division, Grupo Hermes Pardini, Vespasiano, MG, Brazil
,
Elvis Cristian Cueva Mateo
2   Research and Development Division, Grupo Hermes Pardini, Vespasiano, MG, Brazil
,
Danielle Alves Gomes Zauli
2   Research and Development Division, Grupo Hermes Pardini, Vespasiano, MG, Brazil
,
Victor Hugo Melo
3   Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
› Author Affiliations
Further Information

Publication History

20 March 2018

13 June 2018

Publication Date:
19 September 2018 (online)

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Abstract

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.

Resumo

Objetivo Determinar a frequência de infecções sexualmente transmissíveis (ISTs) em mulheres assintomáticas e a associação destas infecções com a neoplasia intraepitelial cervical (NIC).

Métodos Foi realizado um estudo transversal recrutando mulheres atendidas em uma clínica ginecológica geral e em um centro de referência para colposcopia, de outubro de 2014 a outubro de 2015. O grupo de colposcopia consistiu de 71 mulheres, e o grupo de ginecologia geral consistiu de 55 mulheres. Amostras cervicais foram coletadas para citologia cervical e uma reação em cadeia de polimerase (RCP) multiplex em tempo real para detecção do vírus do papiloma humano (HPV) e das ISTs provocadas pelos seguintes micro-organismos: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum e Neisseria gonorrhoeae. Foi realizada uma análise multivariada por regressão logística, considerando-se o nível de significância de 0,05.

Resultados A frequência geral de ISTs foi: 46,8% (HPV); 27,8% (C. trachomatis); 28,6% (M. genitalium); 0,8% (M. hominis); 4,8% (U. urealyticum); e 4,8% (N. gonorrhoeae). Os fatores de risco significantes para NIC foram: infecção pelo HPV (razão de probabilidades [RP] = 2,53; p = 0,024); C. trachomatis (RP = 3,04; p = 0,009); M. genitalium (RP = 2,37; p = 0,04); e coinfecção por HPV e C. trachomatis (RP = 3,11; p = 0,023). Após a análise multivariada, foi encontrada uma associação significante entre HPV e NIC (RP = 2.48; intervalo de confiança de 95% [IC95%]: 1,04–5,92; p = 0,04) e entre C. trachomatis e NIC (RP = 2,69; IC95%: 1,11–6,53; p = 0,028).

Conclusões A frequência de ISTs foi alta em mulheres assintomáticas. Infecções por HPV e C. trachomatis foram independentemente associadas com a presença de NIC. A alta frequência de ISTs em mulheres assintomáticas sugere a necessidade de rastreamento rotineiro dessas infecções.

Keywords

papillomavirus infections - chlamydia - sexually transmitted diseases - polymerase chain reaction - cervical intraepithelial neoplasia

Palavras-chave

infecções por papilomavírus - clamídia - doenças sexualmente transmissíveis - reação em cadeia de polimerase - neoplasia intraepitelial cervical
 

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