title: Association of Trichomonas vaginalis and cytological abnormalities of the cervix in low risk women.
abstract: OBJECTIVE
  Is Trichomonas vaginalis (TV) an inducing factor for the development of (pre-)cancerous lesions of the cervix?
  
  
  METHODS
  Cross sectional study.
  
  
  METHODS
  Screening healthy Belgian women with low infection risk.
  
  
  METHODS
  63,251 consecutive liquid based cervical samples.
  
  
  METHODS
  Real time quantitative PCR for presence of TV, 18 HPV types and Pap smear analysis of cytologic abnormalities.
  
  
  METHODS
  Association of TV and HPV with cervix dysplasia.
  
  
  RESULTS
  The overall prevalence of TV DNA was 0.37%, of low risk HPV 2%, of high risk HPV 13.2%, and 8.8 % had cytological abnormalities. Both LR-HPV and HR-HPV were significantly associated with all cytological abnormalities. Presence of TV was associated with LR- and HR-HPV, ASC-US and HSIL, but not with other abnormalities. All women with TV and HSIL also had HR-HPV, while the latter was present in only 59% of women with TV and ASC-US. Amongst HPV negative women, TV was found in 1.3% of women with ASC-US, but only in 0.03% of women with normal cytology (OR 4.2, CL95% 2.1-8.6). In HR-HPV positive women, presence of TV increased the likelihood of cytological abnormalities somewhat (P=0.05), mainly due to an increase in ASC-US and LSIL, but not HSIL.
  
  
  CONCLUSIONS
  We conclude that TV infection is associated with both LR and HR-HPV infection of the cervix, as well as with ASC-US and HSIL. TV is a concomitant STI, but is not thought to be a co-factor in the causation of HSIL and cervical cancer. However, TV may cause false positive diagnoses of ASC-US.
authors.affiliation: Departments of Obstetrics and Gynecology, University Hospital Antwerpen, Antwerpen, Belgium ; Department of Obstetrics and Gynecology, Heilig Hart Regional Hospital, Tienen, Belgium ; Department Clinical Research for Women, Tienen, Belgium.
authors.forename: Gilbert G G
authors.initials: GG
authors.lastname: Donders
authors.affiliation: Laboratory for Molecular and Clinical Pathology (RIATOL), AML Laboratory Sonic Healthcare Benelux, Antwerp, Belgium.
authors.forename: Christophe E
authors.initials: CE
authors.lastname: Depuydt
authors.affiliation: Laboratory for Molecular and Clinical Pathology (RIATOL), AML Laboratory Sonic Healthcare Benelux, Antwerp, Belgium.
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Bogers
authors.affiliation: Laboratory for Molecular and Clinical Pathology (RIATOL), AML Laboratory Sonic Healthcare Benelux, Antwerp, Belgium.
authors.forename: Annie J
authors.initials: AJ
authors.lastname: Vereecken
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D065006:Papanicolaou Test / Q000379:methods; D030361:Papillomavirus Infections / Q000382:microbiology / Q000473:pathology; D011230:Precancerous Conditions / Q000382:microbiology* / Q000473:pathology* / Q000821:virology; D012307:Risk Factors; D014247:Trichomonas Vaginitis / Q000473:pathology* / Q000821:virology; D014246:Trichomonas vaginalis; D002583:Uterine Cervical Neoplasms / Q000382:microbiology* / Q000473:pathology* / Q000821:virology; D014626:Vaginal Smears / Q000379:methods