Sexually transmitted infections and cervicovaginal dysplasia in a cohort of human immunodeficiency virus-positive women in Turin

The correlation between sexually transmitted infections and cervicovaginal dysplasia has been evaluated in a cohort of 135 women who tested positive f or human immunodeficiency virus type 1 (HIV-1) and were admitted to Amedeo di Savoia Hospital of Turin during the years 1997 and 1998 (stages B2 and B 3 or C2 and C3). Of these women, 31 presented with sexually transmitted dis eases (STDs; mean age, 33.5 +/- 5.9 years). Among them, 14 were affected by cervicovaginal dysplasia of differing severity; human papillomavirus (HPV) infection was found in 13 subjects (10 with cervicovaginal dysplasia). Her pes simplex virus type 2 (HSV-2) infection was detected in six women. Final ly, Trichomonas vaginalis and Candida albicans were found in 10 and in 6 pa tients, respectively. Immunologic and hematologic evaluations were performe d in the patients affected by STDs; in 28 patients of our case report unaff ected by STDs but of similar ages (34.1 +/- 5.6 years) and stage of infecti on; and in 20 HIV-negative women unaffected by STDs. A significant reductio n among the patients affected by STDs, as compared to those unaffected, was found in the case of white cells, CD4+ T cells, and ratio values (CD4+/ an d CD8+ T cells). Moreover, red cell count and hemoglobin concentration were lower in those women in the STD group. A lack of correlation was found bet ween HIV RNA loads and CD4+ T cell counts and between HIV RNA and hemoglobi n concentration in the patients with cervicovaginal dysplasia and in those affected by HSV-2 infection, which differed from the findings in subjects a ffected only by trichomoniasis or candidiasis. This suggests that the two f ormer pathologic conditions (cervico-vaginal dysplasia and HSV-2 infection) ,other than HIV-1 infection, may contribute to the impairment of these valu es. Moreover in our case report. I: vaginalis and HSV-2 infections, which a re suspected to have an oncogenic potential, do not seem to be relevant in the induction or Facilitation of genital neoplastic diseases. Noteworthy is that the patients affected by HSV-2 infection, such as those affected by g enital neoplastic diseases, showed the most compromised Values of total whi te cells, CD4+ T cells, ratio index, red cells, and hemoglobin concentratio n.