Detection of Human papillomavirus and Co-infection With Other Sexually Transmitted Pathogens in Northern Peru

Abstract

Purpose: The epidemiology of human papillomavirus (HPV) and co-infections with other sexually transmitted infections (STIs) remains poorly characterized in Peru. The aim of this study was to identify HPV infections and the presence of co-infections by other important STIs (Chlamydia trachomatis, Trichomonas vaginalis, and Herpes simplex virus) in women attending the public health system in northern Peru. Methods & Materials: We conducted a prospective cross-sectional study in asymptomatic women attending the cervical cancer screening program in a public hospital of Cajamarca, Peru. Exclusion criteria were: pregnancy, recent gynecological bleeding, previous hysterectomy, previous history of HPV-related disease including cervical intraepithelial lesions, cancer, warts and cutaneous manifestations. A cervical swab was collected from each patient using a disposable cytobrush. Detection of sexually transmitted pathogens was performed by polymerase chain reaction (PCR). The pathogens evaluated were: HPV, Chlamydia trachomatis, Trichomonas vaginalis, and Herpes simplex virus 1 (HSV-1) and 2 (HSV-2). Results: A total of 300 asymptomatic women were enrolled in the current study. The pooled prevalence of HPV detected in our study was 19.33% (16.33% as single infection and 3.00% in co-infections) from the total samples. Co-infections between the different pathogens were also observed in 15 cases, being HPV and T. vaginalis the most frequent with 10 cases (66.67%). The most frequent type identified in HPV monoinfections were HPV-16 (16.33%), HPV-52 (14.29%) and HPV-31 (8.16%). Co-infection by multiple HPV types were also identified with up to 4 genotypes at the same time in a single patient The majority of patients with high-risk HPV were between 18 - 39 years old (60.87%) and had a sexual partner in the last 6 months (93.48%). Also, the majority of the patients with high-risk types did not report frequent condom use (89.13%). Conclusion: We found an important prevalence of HPV in asymptomatic women from northern Peru. The most common genotypes were HPV-16, HPV-52 and HPV-31. Among the STIs studied, T. vaginalis was the most common pathogen detected in co-infections with HPV. Education on condom use and timely screening should be encouraged in the Peruvian population to prevent the expansion of HPV and other sexually transmitted pathogens.