Background: Screening of women for Reproductive Tract infection (RTI) e.g. Human Papillomavirus (HPV), Chlamydia trachomatis (C. trachomatis) etc, in developing countries is highly desirable because of asymptomatic infection. Presence of sexually transmitted diseases (STDs) facilitates shedding of human immunodeficiency virus (HIV). Therefore, the present study was conducted to investigate the presence of HPV, C. trachomatis, Trichomonas vaginalis (T.vaginalis) and Neisseria gonorrhoeae (N. gonorrhoeae) infections in HIV-seropositive women in North India.
Methods: The study included a total of 220 women, of which 120 cases were HIV-seropositive, and attending the antiretroviral therapy (ART) clinic at New Delhi. The remaining 100 control subjects were coming for routine check-up in Gynecological clinic. Cervical scrapes were used for evaluation of RTIs with prior informed consent. The samples were tested for HPV, C. trachomatis , T. vaginalis and N. gonorrhoeae by using PCR., and Bacterial vaginosis was detected through cervical cytology.
Results: Among the HIV-seropositive cases, positivity for infections including HPV 19% (23/120), C. trachomatis 12% (14/120), T. vaginallis 6% (7/120) and Bacterial vaginosis was observed 21% (25/120). In control subjects, prevalence of HPV 4% (4/100), C. trachomatis 2% (2/100), T. vaginalis 2% (2/100) and B. vaginosis was observed in 4% (4/100). We observed multiple partners (p=0.0005, OR=0.1933, 95%CI=0.077-0.48) and smoking (p=0.0164, OR=2.54, 95%CI=1.26-4.7) as a positively associated risk factors for RTI. N. gonorrhoeae infection was not observed in any sample. So, prevalence of RTIs is more in HIV patient in comparison to healthy controls.
Conclusions: The presence of HPV, C. trachomatis, T. vaginalis and B. vaginosis infection demonstrates its role in HIV-seropositive women in North India. There is need to continuously screen, counsel, treat and monitor trends of RTIs, Future studies may be conducted on evaluating the role of host genetic factors in the development of RTIs and related complications in symptomatic and asymptotic women.