Associação entre papilomavírus humano, vaginose bacteriana e inflamação cervical e a detecção de anormalidades no exame citológico de adolescentes e mulheres jovens

• Autor(a) principal: Caixeta, Rodrigo Cesar Assis
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/0013000002swr
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/4946
• topic: Papillomavirus humano; VB; Inflamação cervical; SIL; Adolescente; Adulto jovem; HPV; BV; Cervicitis; SIL; Adolescents and young adults; MICROBIOLOGIA APLICADA::MICROBIOLOGIA MEDICA

HPV, BV and CI are common conditions in adolescents and young women. Studies have reported that BV and CI can be cofactors for the acquisition and persistence of HPV, enabling the development of cytological abnormalities precursor of cervical cancer. The aim of this study was to estimate the prevalence of HPV, BV and IC in adolescents and young women and to verify that these conditions are associated with the detection of cytological abnormalities in cervical smears in adolescents and young women. Were included samples of sexually active patients and users of the Unified Health System (SUS) who underwent cervical screening by the conventional method. The cervical specimens were analyzed at the Center for Clinical Analysis Rômulo Rocha, Faculty of Pharmacy/UFG, by qualified professionals following strict quality control. The detection of HPV-DNA was made by PCR using pools of primers PGMY09/PGMY11. The diagnosis of BV was established from the observation of the presence of 20% or more of clue cells in cervical smears. The IC was assessed by counting the number of leukocytes in cervical smears in five noncontiguous with increased microscopic fields 1000X average, according Castle et al. (2001). Statistical analyzes with hierarchical logistic and control of confounding variables regression model were performed. The magnitude of association was estimated by calculating the odds ratio (OR) with confidence intervals (CI*) of 95%. 251 samples were included, with 54,9% (138/251) of adolescents aged between 15 and 19 years and 45,1% (113/251) of young women aged between 20 and 25 years. Positive results for cytological abnormalities accounted for 9,5% (24/251) of all cervical smears. The diagnosis of atypical squamous cells of undetermined significance (atypical squamous cells of undetermined significance - ASCUS) (50,0% 12/24) and squamous intraepithelial lesions (low grade squamous intraepithelial lesion - LSIL) (29,1 % 7/24) were more frequent. The overall prevalence of HPV, BV, and CI 44,2% (111/251), 41,0% (103/251) and 83,2% (209/251), respectively. Of the variables investigated, VB (OR = 2,46 CI*: 1,26 to 3,80; p: 0,006) and the detection of abnormal cytological diagnosis (OR = 1.36 CI*: 1.07 to 1.74; p: 0.013) were associated with HPV positivity in multivariate analysis. Whereas the detection of cytological abnormalities there was a significant association with HPV and BV detected in the same patient (OR = 2,59 CI*: 1,09 to 6,20; p: 0,032) and for the detection of HPV, BV and CI together (OR = 3,58 CI*: 1,06 to 12,15; p: 0,040), however, they didn’t remain independently associated in bivariate analysis. BV and cytological abnormalities were independently associated with HPV infection in adolescents and young women. HPV, BV and CI in cervical smears can indicate high possibility to detect cytological abnormalities in adolescents and young women.