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Open Access Highly Accessed Research article

Detection of sexually transmitted infection and human papillomavirus in negative cytology by multiplex-PCR

Hyo-Sub Shim1, Songmi Noh1, Ae-Ran Park2, Young-Nam Lee1, Jong-Kee Kim3, Hyun-Jae Chung3, Keum-Soon Kang1 and Nam Hoon Cho14*

Author Affiliations

1 Department of Pathology, Yonsei University College of Medicine (Sungsanro 134), Seoul (120-752), South Korea

2 Department of Affairs of Research Biostatistic, Yonsei University College of Medicine (Sungsanro 134), Seoul (120-752), South Korea

3 Seegene Institute of Life Science (Taewon Bldg, 65-5), Seoul (138-050), South Korea

4 Brain Korea 21 Project for Medical Science, Yonsei University (Sungsanro 134), Seoul (120-752), South Korea

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BMC Infectious Diseases 2010, 10:284  doi:10.1186/1471-2334-10-284

Published: 28 September 2010

Abstract

Background

The aim of this study was to determine the prevalence of human papillomavirus (HPV) and 15 species that cause sexually transmitted infections (STIs) in negative cytology. In addition, we compared the diagnostic performance of multiplex polymerase chain reaction (PCR) with widely available techniques used to detect HPV.

Methods

We recruited 235 women of reproductive age who had negative cytology findings in a liquid-based cervical smear. STIs were identified by multiplex PCR, and HPV genotypes by multiplex PCR, hybrid capture 2, and DNA microaray; discordant results were analyzed by direct sequencing.

Results

Approximately 96.6% of patients with negative cytology results were positive for pathogens that cause STIs. The pathogens most frequently detected were Gardnerella vaginalis, Ureaplasma urealyticum. The incidence of HPV in negative cytology was 23.3%. Low-risk HPV infection was significantly correlated with Chalmaydia trachomatis, and high-risk HPV infection was significantly correlated with Group β streptococcus. The analytical sensitivities of the multiplex PCR and DNA microarray were higher than 80%, and the analytical specificity was nearly 100% for all tests.

Conclusions

Multiplex PCR yielded results that most of patients with negative cytology were positive for pathogens that cause STIs, and were more similar to that of DNA microarray, than that of hybrid capture 2 in terms of analytical sensitivity and prediction value of HPV infection.