English

Abstract

AIMS: Prevalence of Sexually transmitted infections (STIs) tends to be high which constitutes an important public health problem at present worldwide and in India, being associated with Human Immunodeficiency virus and predisposing to cervical dysplasia and cancer. There is a need to overcome the STI infections throughout the nation by cytological and microbiological screening. SETTING AND DESIGN: The present study was undertaken to investigate the association of Chlamydia trachomatis (CT), Herpes simplex virus 2 (HSV 2), Cytomegalovirus (CMV), Hepatitis B (HBV), Hepatitis C virus (HCV), Trichomonas vaginalis (TV) and Candidiasis with cervical cytological changes in symptomatic female in West Bengal. METHODS: Sera and vaginal samples from 431 syndromic female patients with cervico-vaginal discharge were tested for detection of STIs. The study period extended over two years. Concomitantly, study of cervical cytology on Papanicolaou stained smears was performed in all cases. ELISA was performed for detection of CT IgM, HSV2 IgM, CMV IgM, HBsAg and HCV IgM in sera. Candida spp. and TV were identified by culture of vaginal samples. Cytological findings were interpreted according to Bethesda 2001 classification. Statistical analysis was performed using MedCalc for Windows, version 13.3.1.0 (MedCalc Software, Ostend, Belgium). RESULTS: Out of 431 samples, majority of the patients belonged to the age group of 29 to 42 years, however the mean age of patients presenting with HSIL on PAP was 45+ 7.93 years. CT, HSV2, TV and Candida spp. were associated with cervical cytological changes of ASCUS or worse. Age greater than 40 years and infection with CT emerged independent risk factors associated with cervical dysplasia on univariate and multivariate analysis with p <0.05 in both. CONCLUSION: C. trachomatis is a risk factor for cervical dysplasia. Early detection and treatment will prevent progression of STIs and development of cervical dysplasia and neoplasia.