Prevalence and factors associated with co-infection of human papillomavirus and Chlamydia trachomatis in adolescents and young women.

Prevalence and factors associated with co-infection of human papillomavirus and Chlamydia trachomatis in adolescents and young women.

Am J Obstet Gynecol. 2016 Jul 8;

Authors: Nonato DR, Alves RR, Ribeiro AA, Saddi VA, Segati KD, Almeida KP, de Lima YA, D'Alessandro WB, Rabelo-Santos SH

Abstract
BACKGROUND: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) share the same route of sexual transmission and possess similar risk factors, indicating that co-infection may act synergistically in the induction of epithelial cell abnormalities.
OBJECTIVES: This study aimed to determine the prevalence of HPV and CT in adolescents and young women and identify factors associated with co-infection.
STUDY DESIGN: This cross-sectional study included 276 female participants, aged 15-24 years, who were sexually active. Interviews were conducted and cervical specimens were collected for cervical smears and molecular tests. All cervical specimens were tested for 27 HPV genotypes by PCR amplification and hybridization to a HPV linear array (Roche). Detection of CT was performed by PCR using primers directed to the region encoding the cryptic plasmid. Bivariate and multivariate analyzes were performed to evaluate the factors associated with co-infection with HPV and CT. The Odds Ratio, the adjusted Odds Ratio, and the 95% confidence interval were calculated.
RESULTS: The prevalence of infection by CT and HPV was 9.1% (95% confidence interval: 5.61-12.4) and 47.1% (95% confidence interval: 41.0-53.2), respectively. The prevalence of co-infection with HPV and CT was 5.8% (95% confidence interval: 3.3-9.2); co-infection with one HPV type was 3.3% (95% confidence interval: 1.5-6.1) and with multiple types was 2.5% (95% confidence interval: 1.0-5.2). The prevalence of cytological abnormalities was 12.3% (95% confidence interval: 8.6-16.79). HPV infections of high oncogenic risk were more prevalent (85.4%). Factors independently associated with co-infection HPV/CT obtained by multivariate analysis were the initiation of sexual activity under 16 years of age with an Odds Ratio of 4.9 (95% confidence interval: 1.0-23.63; p = 0.05) and cytological abnormalities with an Odds Ratio of 10.7 (95% confidence interval: 1.9-59.5; p = 0.01) which indicates there is risk for the detection of cytological abnormalities in adolescents and young women coinfected with HPV / CT.
CONCLUSIONS: The prevalence of co-infection among our study population was of a magnitude that warrants attention by public health services. Adolescents and young women should be monitored for CT infection and vaccinated against HPV. The association between cytological abnormalities and co-infection with HPV and CT indicates the potential synergistic role of these infections in carcinogenesis of the cervix.

PMID: 27402054 [PubMed - as supplied by publisher]

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