Human Papilloma Virus Research

Simoes-Barbosa A, Lobo TT, Xavier J, Carvalho SE, Leornadecz E. Universidade Catolica de Brasilia, Programa de Pos-graduacao em Ciencias Genomicas e Biotecnologia, SGAN 916, Brasilia, DF 70790-160, Brazil.

Trichomoniasis presents a broad spectrum of clinical patterns ranging from asymptomatic to severe vaginitis and cervicitis. Despite its importance, very little is known about the genetic relatedness of its causative agent, Trichomonas vaginalis, and the clinical phenotypes. To address this question, analysis of restriction length polymorphism (RFLP) within the intergenic spacer of the ribosomal DNA (IGS) from 60 clinically defined isolates of T. vaginalis was performed. This is the first description of the IGS polymorphism of T. vaginalis. As expected, a considerable number of patients were asymptomatic (28%) while only 12% presented both leukorrhea and macular colpitis, the most evident symptoms of trichomoniasis. The IGS-RFLP with the use of eight restriction enzymes showed absence of correlation between the genetic relatedness of the isolates and symptomatology. Further studies are necessary to evaluate the importance of the IGS polymorphism to the parasite virulence and clinical phenotype.

Adolesc Med Clin. 2004 Jun;15(2):253-71.

Urethritis and cervicitis in adolescents.

Simpson T, Oh MK. Department of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, Suite 201-MTC, Birmingham, AL 35233-1711, USA.

Sexually acquired lower-genitourinary tract infections are a significant source of morbidity for adolescents. Causative organisms include T. vaginalis, Mycoplasma organisms, Ureaplasma organisms, and, most commonly, N. gonorrhoeae and C. trachomatis. With NAATs, noninvasive screening can be accomplished easily. The importance of screening in high-risk populations cannot be overemphasized, especially because these infections are often asymptomatic. The treatment of sexually transmitted bacterial infections includes appropriate antibiotic treatment for the presenting patient, partner identification and treatment, and counseling to prevent reinfection.

Publication Types:
• Review
• Review, Tutorial

J Pediatr Adolesc Gynecol. 2005 Feb;18(1):33-8.

Are adolescent girls with Chlamydia infection notifying their partners?

Lim SW, Coupey SM. Albert Einstein College of Medicine / Children's Hospital At Montefiore, 111 East 210th Street, Bronx, NY 10467, USA.

OBJECTIVES: (1) To determine the proportion of inner-city adolescent girls diagnosed with chlamydial cervicitis who notify their sex partners; (2) to examine girls' attitudes and perceptions about partner notification and treatment; and (3) to assess whether or not girls knew if their partners were treated for chlamydia infection. DESIGN/METHODS: Adolescent girls who had a positive DNA hybridization test for chlamydial cervicitis from March 2000 to May 2002 completed a 37-item self-administered survey assessing sexual behavior and partner notification, as well as the Rosenberg self esteem scale. Subjects completed the survey 1-3 months after the diagnosis of chlamydia infection. RESULTS: Fifty-five adolescent girls (46% Hispanic, 36% African American) aged 13-21 years (mean 18.3 years) completed the survey. The median age at first intercourse was 14 (SD = 1.6); median number of lifetime sex partners was 4. Forty-one subjects (75%) notified their sex partners. The most common reasons for partner notification were"I did not want my sex partner to give the infection back to me"and"I wanted to let my sex partner know that he/she had given me the infection". There was a trend toward increased notification if the girls were 18 years of age or older (P = 0.07) or had only one lifetime sex partner (P = 0.08). Of the 41 subjects who notified their partners, 22 (54%) reported that the partners were treated; 16 did not know, and three knew that partners were not treated. CONCLUSIONS: The majority of inner-city girls in this study notified their partners about chlamydia infection. Self-protection from re-infection was an important reason given for notification and suggests that girls in committed ongoing relationships might be more likely to notify partners.

Ginekol Pol. 2005 Jan;76(1):28-32.

The presence of Mycoplasma hominis and Ureaplasma urealyticum in the cervical canal of uterus

Human Papilloma Virus Research - Article in Polish

OBJECTIVES: Mycoplasma hominis and Ureaplasma species are common commensal inhabitants of the lower genitourinary tract in adolescents and adults who are sexually active. A lot of authors points out that these microorganisms can play an important role in pathology of genital tract like pelvic inflammatory disease, sterility or non-gonococcal urethritis. MATERIALS AND METHODS: In the study samples from cervical canal of the uterus were obtained from 222 women. The first group consist of 132 women who were examined in II Gynecological Clinic in Wroclaw for different, probably infectious, gynecological pathologies (adnexitis, sterility, bacterial vaginosis). 90 women without infectious diseases were in a control group. All swabs taken from cervix were tested for Mycoplasma hominis and Ureaplasma urealyticum. RESULTS: The prevalence of Ureaplasma urealyticum was 31.8% in the first tested group (42 of 132 women were positive) and 8.8% in control group (8 of 90 were positive). 3% (4 of 132) of patients were positive to Mycoplasma hominis in the first group and only 1.1% (1 of 90) in a control group. CONCLUSIONS: Ureaplasma urealyticum was found most often in such genital tract pathologies like acute or recurrent adnexitis, sterility or bacterial vaginosis. No statistically significant correlation was found between the age of the patients and the incidence of mycoplasmas.

Arch Gynecol Obstet. 2005 Mar 19; [Epub ahead of print]

The demographic and behavioural profile of women with cervicitis infected with Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum and the comparison of two medical regimens.

Guven MA, Gunyeli I, Dogan M, Ciragil P, Bakaris S, Gul M. Department of Obstetrics and Gynecology,, Kahramanmaras Sutcuimam University, School of Medicine, Hastane cad. No: 32, 46050, Kahramanmaras, Turkey.

Objective: The aim of this study was to compare the therapeutic effect of single dose oral azithromycin with twice-daily, 7-day doxycycline in women with chlamydial, mycoplasmic or ureaplasmic cervicitis and to demonstrate the demographic and behavioral profile of infected women. Materials and methods: Five hundred and thirty-three women with various gynecologic complaints were recruited for this study. All women were screened for Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) by enzyme immune assay tests. Patients positive for Neisseria gonorrhoeae were excluded. Women treated for these infections were tested after completing medical therapy. Educational levels of infected women were similar in each group. The prevalence of CT, UU and MH was 3.4% (18/533), 11.8% (63/533) and 0.9% (5/533), respectively. In 452 patients, no treatment was administered. The remaining patients were either treated with azithromycin (n=41) or doxycycline (n=40). The eradication rate for the infectious agents was 87.3% and 93.5% in the group of azithromycin and doxycycline, respectively (P>0.05). There was no statistically significant difference in efficacy between single dose azithromycin and a 7-day course of doxycycline with respect to the treatment of culture-positive cases. Recurrences were observed in five cases in azithromycin group (12.5%) and in three cases in doxycycline group (7.5%) . Conclusions: The treatment of uncomplicated chlamydial, mycoplasmic and ureaplasmic cervicitis with a single dose of azithromycin administered under supervision in the clinic is as effective as a 7-day course of doxycycline. This regimen may overcome the problem of compliance with the standard twice-daily, 7-day regimen of doxycycline.

Sichuan Da Xue Xue Bao Yi Xue Ban. 2005 Jan;36(1):101-4.

Analysis on the relative factors of trichomonal vaginitis in married childbearing age women in rural impoverished area

Human Papilloma Virus Research - Article in Chinese

OBJECTIVE: To investigate the status and relative factors of trichomonal vaginitis among married childbearing age women in rural impoverished area of the northwestern part of China and hence identify the risk factors and provide a basis for the prevention and treatment of trichomonal vaginitis. METHODS: Questionnaire investigation, gynecological and laboratory examination were carried out in 480 women who had been selected by multi-stage cluster sampling in rural impoverished area of Bao Ji in ShannXi province. A case-control study was conducted to analyze the relative factors of trichomonal vaginitis and other reproductive tract infection (RTI) complications. RESULTS: The prevalence rate of trichomonal vaginitis was 12.9%, and 64.5% of the cases were complicated with chronic cervicitis, 17.7% were complicated with adnexitis. Uni-variated and multi-variated logistic regression analyses revealed that lack of reproductive health knowledge, bath with polluted water, washing vulva or penis with polluted water before sexual intercourse, having intercourse during menstrual period, having past history of trichomonal vaginitis, as well as no-income woman's and husband's negative attitude towards wife's RTIs were risk factors of trichomonal vaginitis and complicating chronic cervicitis or adnexitis. And lack of reproductive health knowledge, bath with polluted water, washing penis with polluted water before sexual intercourse, past history of trichomonal vaginitis, husband's negative attitude to wife's RTIs were relative factors of trichomonal vaginitis and complicating chronic cervicitis or adnexitis revealed by the binary logistic regression analysis. The less score of reproductive health knowledge, the more risk of suffering from trichomonal vaginitis complicating chronic cervicitis. CONCLUSION: Compositive and successive prevention and treatment scheme should be used to control trichomonal vaginitis and other RTI complications in rural impoverished area of northwestern China. The scheme should be focused on four ways, including improving sanitation behaviors in couples, insisting on normative treatment, generalizing reproductive health knowledge and mobilizing husbands to pay attention.

BJOG. 2004 Dec;111(12):1464-7.

Prevalence of Mycoplasma genitalium in early pregnancy and relationship between its presence and pregnancy outcome.

Oakeshott P, Hay P, Taylor-Robinson D, Hay S, Dohn B, Kerry S, Jensen JS. Community Health Sciences, St George's Hospital Medical School, London SW17 ORE, UK.

Mycoplasma genitalium is associated with cervicitis and pelvic inflammatory disease but little is known about its role in pregnancy. We investigated the prevalence of M. genitalium by polymerase chain reaction assay on urine specimens from 1216 pregnant women (mean age 31years) presenting before 10 weeks of gestation in 32 general practices. The prevalence of M. genitalium was 0.7% (6/915, 95% CI 0.1-1.2). It was more common in women aged < 20 years, women of Afro-Caribbean or black African ethnic origin, women in social classes 3-5 and single women. Only one woman with M. genitalium infection miscarried, and none of those followed up to term had a preterm birth, although the numbers were small. The low prevalence of M. genitalium infection suggests it is unlikely to be an important risk factor in adverse pregnancy outcome in healthy women in the community.

Publication Types:
• Multicenter Study

Human Papilloma Virus Research - HPV and Other Genital Infections Links

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