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

H J Alotaibi; F N Almajhdi; A N Alsaleh; D A Obeid; H H Khayat; T A Al-Muammer; A M Tulbah; M B Alfageeh; M N Al-Ahdal; F S Alhamlan

doi:10.1016/j.sjbs.2020.03.021

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

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

Authors

H J Alotaibi¹, F N Almajhdi¹, A N Alsaleh¹, D A Obeid², H H Khayat², T A Al-Muammer³, A M Tulbah⁴, M B Alfageeh⁵, M N Al-Ahdal^{2

6}, F S Alhamlan^{2

6}

Affiliations

¹ Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia.
² Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
³ Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁴ Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁵ Infectious Diseases Program, National Center for Biotechnology, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.
⁶ College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

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.