Associations between sexually transmitted infections and cervical precancerous lesions in Latvian women

Introduction: Vaginal microbiome and sexually transmitted infections play a role in the acquisition and persistence of human papilloma virus, thus leading to cervical carcinogenesis (Adebamowo, 2017; Kim, 2016). There are studies that show relations between Mycoplasma genitalium infection and cervical precancerous diseases (Adebamowo, 2017; Gomih-Alakija, 2014; Yin, 2013), but still the data remain controversial. Objective(s): To identify associations between sexually transmitted infections and cervical precancerous lesions in Latvian women. Method(s): Cross-sectional study was performed in July 2016-June 2017. 95 patients with abnormal cytology referred for colposcopy to Riga East Clinical University Hospital Colposcopy reference center were included in the study group. 55 patients from outpatient clinic in Riga with normal cytology were chosen as controls. Material from cervix and upper vaginal fornix was taken for testing M. genitalium, Chlamydia trachomatis and Herpes simplex types 1 and 2 using Real Time PCR method. Colposcopy was performed and cervical biopsies were sent to histological analysis. Data analysis was performed with MS Excel 2016. Discussion and conclusions: 21 patients with Cervical Intraepithelial Neoplasia grade 1 (CIN 1), 51 with CIN 2, 20 with CIN 3 and 1 patient with cervical cancer IA1 were included in the study. M. genitalium was found in 6/21 (29%) CIN 1 cases, 19/51 (37%) CIN 2, 7/20 (35%) CIN 3 and in 1/1 (100%) cervical cancer patient. In control group M. genitalium was isolated from 19/55 (35%) of women and there is no statistically significant difference between study and control groups. When analyzing association of M. genitalium infection with severity of cervical precancer we also did not find any differences. M. genitalium was isolated from 27/72 (38%) of CIN 2+ patients. C. trachomatis and H. simplex types 1 and 2 prevalence did not differ in study and control groups. Our data show that level of M. genitalium infection in women with and without cervical precancerous disease in Latvia is high and there is no significant difference between both groups. We also did not find association between C. trachomatis and H. simplex infection and cervical pathology. Further and larger study is needed to confirm our findings.