Chlamydia trachomatis and human papillomavirus infection in Indian women with sexually transmitted diseases and cervical precancerous and cancerous lesions

Objectives Sexually transmitted diseases (STDs) and anogenital cancers are the major health problems in Indian women but no reliable estimate of the p revalence of either genital chlamydial infection or human papillomavirus (H PV) infection in Sm patients is available. The aim of this study was to det ect the frequency of Chlamydia trachomatis and the most prevalent high-risk HPV type 16 (HPV 16) infection in Indian women, with STDs and precancerous and cancerous lesions of the uterine cervix by polymerase ch;tin reaction (PCR), and their comparison with those of conventional serology; and antige n tests used for C. trachomatis detection. Methods Endocervical swabs or scrapes were collected from 50 women with STD s and 30 normal healthy women attending the STD clinics of Smt. Sucheta Kri palani Hospital, New Delhi. Scraped cervical cell specimens were also colle cted from 50 women with precancerous and cancerous lesions of the uterine c ervix. Detection of C. trachomatis and HPV was carried out by PCR using chl amydia and HPV genome-specific oligonucleotide primers. The detection of ch lamydial antigen and IgG-specific antibodies was carried out by enzyme immu noassay (EIA) and serological enzyme-linked immunosorbent assay (ELISA), re spectively. Results A chlamydia plasmid-based PCR assay detected 50% (25 of 50) positiv ity of C. trachomatis in STD patients and HPV 16 DNA was found in 30% (15 o f 50) of these cases which are significantly higher than those found in hea lthy controls. The PCR estimate of chlamydia was found to be higher than it s reported frequency bu tissue culture. The EIA could detect chlamydial ant igen in only 13 cases (26%) while serological ELISA revealed evidence of ch lamydia IgG-specific antibodies in 26 (52%) cases. Interestingly, in women with precancerous and cancerous lesions, the rate of HPV 16 infection was v ery high (52% and 72%, respectively), whereas the frequency of chlamydia in fection was found to be 12-22% only. Occurrence of other sexually transmitt ed agents was also evaluated in the women. Conclusions This is the first PCR estimate of genital chlamydial (50%) and HPV 16 (30%) infection in STD patients and women with precancerous and canc erous lesions of the uterine cervix in India. The PCR method seems to be a good alternative to tissue culture.