Cervical Viral Infections among Asymptomatic Bulgarian Women

Abstract

SUMMARYAim: Although sexually transmitted viral infections are significant and increasing public health concern, little is known about their prevalence among Bulgarian women. The aim of this study was to investigate cervical viral infections in asymptomatic women.Methods: The study group included 52 randomly selected asymptomatic female volunteers from Bulgarian border town Kardzhali. Cervical specimens were tested by real-time PCR for human papillomaviruses (HPV), herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV).Results: The investigation demonstrated a high rate (61.5%) of infection with one or more viruses of uterine cervix of participating women considered at low risk. The most prevalent was HPV, found in 32.7% of all women. The genotyping of high-risk (HR) HPV positive specimens showed that HPV16 was the most prevalent HR type. HSV prevalence (30.8%) was almost as high as that of HPV and most women were HSV1 infected. 9.6% and 5.8% of all specimens were positive for EBV and CMV, respectively.Conclusions: Our results indicate that women from Kardzhali region, involved in this study, might be at risk for development of genital tract pathology, including cervical cancer, and for transmission of virus infection sexually and perinatally.

Pre-vaccination prevalence of high-risk human papillomaviruses (HPV) in women from Kosovo and their related sociodemographic characteristics

“…In the female population from Kosovo, the crude overall prevalence of infection with any of the 14 HR-HPVs was estimated at 13.1%. Interestingly, in our study population the overall HR-HPV prevalence in NILM was lower than in studies on a total of 10.744 eligible women from other countries in central and eastern Europe (9.7%; 95% CI: 6.1-15.2% vs. 18.0%; 95% CI: 17.0-19.0%, respectively) [15][16][17][18][19][20][21][22][23], with reported high incidence rates of cervical cancer and related mortality rates [1]. Our results were concordant with those obtained in the largest study in the region to date, performed on 4.199 Slovenian women (HR-HPV prevalence of 10.7%; cervical cancer incidence rate per 100,000: 13.4; mortality rate due to cervical cancer per 100,000: 6.1) [1,14], as well as with global data (HR-HPV prevalence of 10.4%; cervical cancer incidence rate per 100,000: 15.1; mortality rate due to cervical cancer per 100,000: 7.6) [1,5].…”

Co-existing of HSV1/2 or EBV Infection with the Presence of High-Risk HPV DNA in Cervical Lesions in the Southwest of Iran

“…Similarly, a study from Poland reported an EBV co-existence among 14% HPV positive specimens (Szostek et al, 2009a). However, the study from Bulgaria showed that just 9.6% of all specimens were positive for EBV and HPV simultaneously (Staykova et al, 2016). Also, a higher prevalence of EBV coexisting with HPV reported from India (20%) (Silver et al, 2011), Thailand (32%) (Aromseree et al, 2015) and Syria (34%) (Al-Thawadi et al, 2018), demonstrating a more important role of EBV as a cofactor.…”

“…It was also suggested that viral co-existence might also make the progression of cervical lesions faster into cervical cancer. The coexisting of sexually transmitted viruses such as Herpes simplex viruses (HSV1, 2), Cytomegalovirus, Epstein-Barr virus (EBV) and, Human immunodeficiency virus are supposed to enhance the infection or disease progress during HPVs persistence (Staykova et al, 2016). EBV and HSV belong to the Herpesviruses that persistently infect the majority of the adult population.…”

The Role of Epstein–Barr Virus in Cervical Cancer: A Brief Update

“…As correctly observed in the meta-analysis of de Lima et al ( 12 ), EBV along with cytomegalovirus (CMV) may also be detected in cervical secretions and uterine cervix from healthy young women. Several studies confirmed the frequency of EBV and CMV in cervical secretions among healthy women to be between 10 and 30% ( 67 – 70 ). Such findings may also be clinically relevant given that viruses such as CMV, HSVs, and varicella zoster may cause congenital, perinatal, or neonatal infections ( 67 ).…”