ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1480959
High frequency of sexually transmitted infections in patients with precancerous cervical lesions in Brazil
Provisionally accepted
Kerellyn Follador1,2
Leticia Viçosa Pires1,2*
Ana Paula Zanella Corbellini1,2
Mariana da Silveira Suñé1,2
Helena Mansur1,2
Priscila Lamb Wink1,2
Fernanda Uratani1,2
Giovana Cabrera1,2
Regis Kreitchmann1,2Rosilene Jara Reis1,2
Giovana Rosin1,2
Jefferson Henrique Zwir Poli1,2
Alessandro Comarú Pasqualotto1,2- 1Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
- 2Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Introduction: Cervical cancer is strongly associated with persistent human papillomavirus (HPV) infection, the most common sexually transmitted infection (STI) worldwide. While most infections are cleared naturally, co-infections with non-HPV STIs may contribute to HPV persistence and disease progression. Unlike cervical cancer, which has a national screening program in Brazil, STI screening remains unstructured, with prevalence varying across regions. Objective: To evaluate the prevalence of HPV co-infections with Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Neisseria gonorrhoeae, Ureaplasma urealyticum, and Trichomonas vaginalis in patients diagnosed with cervical intraepithelial neoplasia (CIN) in Porto Alegre, Brazil. Methods: This cross-sectional study included patients with histologically confirmed precancerous cervical lesions attending a referral outpatient clinic. Between October 2022 and December 2023, 159 patients were enrolled and screened for the presence of non-HPV STI co-infections through cervical secretion DNA-qPCR testing. Results: Most (64.8%) participants were diagnosed with CIN IIor III. Among all patients analyzed, nearly 60% had at least one non-HPV STI co-infection associated with low-or high-grade cervical lesions. The most prevalent pathogen was U. urealyticum (44%), followed by M. hominis (16.3%) and C. trachomatis (10.1%).A high prevalence of non-HPV STI co-infections was observed in asymptomatic women with CIN, particularly U. urealyticum, which has been identified as a potential cofactor in HPVrelated carcinogenesis. Our findings contribute to the growing body of national and international literature supporting the need for integrating STI screening into cervical cancer prevention strategies for sexually active women in Brazil.
Keywords: sexually transmitted infections1, human papilloma virus (HPV)2, chlamydia3, ureaplasmaurealyticum4, cervical intraepithelial neoplasia5, cervical cancer6
Received: 14 Aug 2024; Accepted: 05 May 2025.
Copyright: © 2025 Follador, Viçosa Pires, Corbellini, Suñé, Mansur, Wink, Uratani, Cabrera, Kreitchmann, Reis, Rosin, Poli and Comarú Pasqualotto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Leticia Viçosa Pires, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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