Abstract
Cervical cancer is a preventable public health concern ranking second among women’s cancer in Cameroon. <i>Human papilloma virus</i> (HPV) is the main causative agent with <i>Chlamydia trachomatis</i> being suggested as the co-factor. Our objective was to characterize high risk (hr) HPV types and to detect <i>Chlamydia trachomatis</i> antibodies among Cameroonian women with and without cervical cancer. <i>Methods</i>: This unmatched case-control study enrolled 100 cases with cervical cancer and 200 controls with normal cytology aged 25- 65 years in four reference hospitals in Douala and Yaoundé (Cameroon). Consented participants filled a structured questionnaire and data on socio-demographic characteristics collected. <i>Chlamydia trachomatis</i> antibodies were detected by the Enzyme Linked Immuno-Sorbent Assay technique (ELISA) and hr HPV- DNA by PCR technique. Descriptive statistics was conducted to provide frequencies and percentages and the logistic regression analysis to assess the association between categorical data. p < 0.05 was considered significant. <i>Results</i>: Our data showed 39 (39.0%) cases aged 39-52 years compared to 96 (48.0%) controls aged 25-38 years (p=0.001). We found 82 (82.0%) cases compared to 131 (65.5%) controls with hr HPV infections. HPV 16 was most prevalent being found in 29 (29.0%) cases compared to 69 (34.5%) controls. <i>Chlamydia trachomatis</i> IgG / hr HPV co-infections were detected in 20 (20.0%) cases compared to 33 (16.5%) controls but with no significant association with cervical cancer (aOR=1.87; 95%CI: 0.58-5.97; p=0.293). <i>Chlamydia trachomatis</i> IgM (aOR=3.50; 95%CI: 1.16-10.49; p=0.025) was significantly associated with cervical cancer. <i>Conclusion</i>: Hr HPV- DNA was high in cases than in controls. <i>Chlamydia trachomatis</i> single infection and <i>Chlamydia trachomatis</i>/hr HPV co-infections were not significantly associated to precancerous lesions thus, necessitating further investigations.
Highlights
IntroductionAlmost all cervical cancers are caused by persistent infection with certain types of Human papilloma virus (HPV) [2]
The Human papilloma virus (HPV) family comprises more than 200 different types [1]
We found high prevalence of hr HPV infections among cases compared to controls which was similar to the findings of another study in Brazil (2016) which reported high prevalence of HPV in women with low grade squamous intraepithelial lesions (LSIL) than in women with negative cytology [25]
Summary
Almost all cervical cancers are caused by persistent infection with certain types of HPV [2]. Infections caused by high risk (hr) HPV are responsible for 7.7% cases of cervical cancer mainly in developing countries [3, 4]. A number of factors have been found to contribute to cervical cancer including: high parity, tobacco smoking, longterm hormonal contraceptive use, co-infection with C. trachomatis, Herpes simplex virus type 2, HIV, immunosuppression, certain dietary deficiencies, cancer, European Journal of Clinical and Biomedical Sciences 2020; 6(5): 90-99 imbalanced vaginal flora, having an uncircumcised male partner and low socio-economic status [1, 6]. Most STIs are suggested to be associated with an inflammatory response/process which facilitate HPV entry into target cells, as well as with the persistence of infection [7]
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