{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:15:30Z","timestamp":1787030130664,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ROCHE DIAGNOSTICS GmbH","award":["F24-096"],"award-info":[{"award-number":["F24-096"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>High-risk human papillomavirus (HR-HPV) and other sexually transmitted infections (STIs-O) are promoters to the development of cervical cancer (CC), especially when they co-exist. This study aims to determine the prevalence of the major STIs-O and the rate of co-infection in women previously diagnosed with HR-HPV infection. For this observational study, 254 women aged 25\u201365 years who were being followed up for HR-HPV infection (without a CC history) were recruited at a hospital\u2019s Gynaecology Department from February 2024 to November 2024. Their endocervical specimens were collected and processed for HR-HPV, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis detection by RT-PCR using commercially available reagents and equipment. The overall rate of infection was 38.6% for HPV and 4.3% for ITSs-O (3.8% in HPV-negative women and 5.1% in HPV-positive women). The presence of ITSs-O in women aged 25\u201334 was higher in those with a persistent positive result for HR-HPV (20.0% vs. 4.2%). Diverse multiple co-infections were found in HPV-positive women, whilst some single STIs-O were found in HPV-negative women. These results support the benefits of STI-O screening beyond an HR-HPV positive result, especially in those women under 35 years old.<\/jats:p>","DOI":"10.3390\/v17020247","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:01:08Z","timestamp":1739271668000},"page":"247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["HPV-Associated Sexually Transmitted Infections in Cervical Cancer Screening: A Prospective Cohort Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9932-0124","authenticated-orcid":false,"given":"Miriam","family":"Latorre-Mill\u00e1n","sequence":"first","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5263-4414","authenticated-orcid":false,"given":"Alexander","family":"Tristancho-Bar\u00f3","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1982-1469","authenticated-orcid":false,"given":"Natalia","family":"Burillo","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Ariza","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3888-8952","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Milagro","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Abad","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Baquedano","sequence":"additional","affiliation":[{"name":"Gynaecology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Borque","sequence":"additional","affiliation":[{"name":"Gynaecology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7294-245X","authenticated-orcid":false,"given":"Antonio","family":"Rezusta","sequence":"additional","affiliation":[{"name":"Research Group on Infections Difficult to Diagnose and Treat, Institute for Health Research Arag\u00f3n, Miguel Servet University Hospital, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","unstructured":"Asociaci\u00f3n Espa\u00f1ola Contra el C\u00e1ncer (AEECC) (2024, December 19). Dimensiones del C\u00e1ncer. Available online: https:\/\/observatorio.contraelcancer.es\/explora\/dimensiones-del-cancer."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Li, X.-Y., Li, G., Gong, T.-T., Lv, J.-L., Gao, C., Liu, F.-H., Zhao, Y.-H., and Wu, Q.-J. (2023). Non-Genetic Factors and Risk of Cervical Cancer: An Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies. Int. J. Public Health, 68.","DOI":"10.3389\/ijph.2023.1605198"},{"key":"ref_3","unstructured":"Organisation for Economic Co-Operation and Development (2023). EU Country Cancer Profile: Spain 2023, OECD Publishing. EU Country Cancer Profiles."},{"key":"ref_4","unstructured":"(2024, December 18). Recomendaciones de la Sociedad Espa\u00f1ola de Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica (SEIMC) para el Cribado de Cancer de Cuello de \u00datero. Available online: https:\/\/seimc.org\/contenidos\/inf_institucional\/recomendacionesinstitucionales\/seimc-rc-2013-1.pdf."},{"key":"ref_5","unstructured":"Procedimientos en Microbiolog\u00eda Cl\u00ednica, Cercenado Mansilla, E., and Cant\u00f3n Moreno, R. (2016). Diagn\u00f3stico Microbiol\u00f3gico de la Infecci\u00f3n por el Virus del Papiloma Humano. 57, Sociedad Espa\u00f1ola de Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica (SEIMC). Mateos Lindemann ML (coordinator)."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Koster, S., Gurumurthy, R.K., Kumar, N., Prakash, P.G., Dhanraj, J., Bayer, S., Berger, H., Kurian, S.M., Drabkina, M., and Mollenkopf, H.-J. (2022). Modelling Chlamydia and HPV co-infection in patient-derived ectocervix organoids reveals distinct cellular reprogramming. Nat. Commun., 13.","DOI":"10.1038\/s41467-022-28569-1"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Yang, D., Zhang, J., Cui, X., Ma, J., Wang, C., and Piao, H. (2022). Status and epidemiological characteristics of high-risk human papillomavirus infection in multiple centers in Shenyang. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.985561"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Liu, Z., Li, P., Zeng, X., Yao, X., Sun, Y., Lin, H., Shen, P., Sun, F., and Zhan, S. (2022). Impact of HPV vaccination on HPV infection and cervical related disease burden in real-world settings (HPV-RWS): Protocol of a prospective cohort. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14474-1"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Gillet, E., Meys, J.F.A., Verstraelen, H., Verhelst, R., De Sutter, P., Temmerman, M., and Broeck, D.V. (2012). Association between bacterial vaginosis and cervical intraepithelial neoplasia: Systematic review and meta-analysis. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045201"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1055\/s-0038-1669994","article-title":"Sexually Transmitted Infections Detected by Multiplex Real Time PCR in Asymptomatic Women and Association with Cervical Intraepithelial Neoplasia","volume":"40","author":"Hoelzle","year":"2018","journal-title":"Rev. Bras. Ginecol. Obs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajog.2018.12.011","article-title":"Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: Systematic review and meta-analysis","volume":"221","author":"Brusselaers","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Mosmann, J.P., Zayas, S., Kiguen, A.X., Venezuela, R.F., Rosato, O., and Cuffini, C.G. (2021). Human papillomavirus and Chlamydia trachomatis in oral and genital mucosa of women with normal and abnormal cervical cytology. BMC Infect Dis., 21.","DOI":"10.1186\/s12879-021-06118-3"},{"key":"ref_13","unstructured":"U.S. Centers for Diseases Control and Prevention (2024, December 17). Getting Tested for STIs, Available online: https:\/\/www.cdc.gov\/sti\/testing\/index.html."},{"key":"ref_14","unstructured":"Holmes, K.K., Bertozzi, S., Bloom, B.R., and Jha, P. (2017). Sexually Transmitted Infections: Impact and Cost-Effectiveness of Prevention. Major Infectious Diseases, The International Bank for Reconstruction and Development\/The World Bank. [3rd ed.]."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Mendoza, L., Mongelos, P., Paez, M., Castro, A., Rodriguez-Riveros, I., Gimenez, G., Araujo, P., Echag\u00fce, G., Diaz, V., and Laspina, F. (2013). Human papillomavirus and other genital infections in indigenous women from Paraguay: A cross-sectional analytical study. BMC Infect Dis., 13.","DOI":"10.1186\/1471-2334-13-531"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1002\/hpm.3665","article-title":"Challenges of hesitancy in human papillomavirus vaccination: Bibliometric and visual analysis","volume":"38","author":"Deng","year":"2023","journal-title":"Int. J. Health Plann. Manag."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0301-2115(98)00016-5","article-title":"Evaluation of cervical dysplasia treatment by large loop excision of the transformation zone (LLETZ). Does completeness of excision determine outcome?","volume":"78","author":"Sala","year":"1998","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1001\/jama.2021.0725","article-title":"HPV Vaccination Among Young Adults in the US","volume":"325","author":"Chen","year":"2021","journal-title":"JAMA"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Robial, R., Longatto-Filho, A., Roteli-Martins, C.M., Silveira, M.F., Stauffert, D., Ribeiro, G.G., Linhares, I.M., Tacla, M., Zonta, M.A., and Baracat, E.C. (2017). Frequency of Chlamydia trachomatis infection in cervical intraepithelial lesions and the status of cytological p16\/Ki-67 dual-staining. Infect. Agents Cancer, 12.","DOI":"10.1186\/s13027-016-0111-8"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1136\/sti.78.6.406","article-title":"Cost effectiveness of screening for Chlamydia trachomatis: A review of published studies","volume":"78","author":"Honey","year":"2002","journal-title":"Sex Transm. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lu, Z., Zhao, P., Lu, H., and Xiao, M. (2023). Analyses of human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, and co-infections in a gynecology outpatient clinic in Haikou area, China. BMC Women\u2019s Health, 23.","DOI":"10.1186\/s12905-023-02259-6"},{"key":"ref_22","unstructured":"ICO\/IARC Information Centre on HPV and Cancer (2024, December 17). Spain: Human Papillomavirus and Related Cancers, Fact Sheet. Available online: https:\/\/hpvcentre.net\/statistics\/reports\/ESP_FS.pdf."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0304-5013(05)72377-3","article-title":"Prevalencia del virus del papiloma humano en una muestra de poblaci\u00f3n urbana en la ciudad de Zaragoza","volume":"48","author":"Puig","year":"2005","journal-title":"Prog. Obstet. Ginecol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rodriguez-Cerdeira, C., Sanchez-Blanco, E., and Alba, A. (2012). Evaluation of Association between Vaginal Infections and High-Risk Human Papillomavirus Types in Female Sex Workers in Spain. ISRN Obstet. Gynecol., 2012.","DOI":"10.5402\/2012\/240190"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1002\/ijc.28665","article-title":"Prospective Seroepidemiologic Study on the Role of Human Papillomavirus and Other Infections in Cervical Carcinogenesis: Evidence from the EPIC Cohort","volume":"135","author":"Castellsague","year":"2014","journal-title":"Int. J. Cancer"},{"key":"ref_26","unstructured":"Grupo de Trabajo Sobre Cribado de C\u00e1ncer de C\u00e9rvix (2024, December 19). Documento de consenso sobre la modificaci\u00f3n del Programa de Cribado de C\u00e1ncer de C\u00e9rvix. Ministerio de Sanidad. Direcci\u00f3n General de Salud P\u00fablica y Equidad en Salud. S.G. de Promoci\u00f3n de la Salud y Prevenci\u00f3n, Available online: https:\/\/www.sanidad.gob.es\/areas\/promocionPrevencion\/cribado\/cribadoCancer\/cancerCervix\/docs\/DocumentoconsensomodificacionCervix.pdf."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1136\/sextrans-2020-054873","article-title":"Assessing the costs and outcomes of control programmes for sexually transmitted infections: A systematic review of economic evaluations","volume":"97","author":"Bloch","year":"2021","journal-title":"Sex Transm. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Schnitzler, L., Jackson, L.J., Paulus, A.T.G., Roberts, T.E., and Evers, S.M.A.A. (2021). Intersectoral costs of sexually transmitted infections (STIs) and HIV: A systematic review of cost-of-illness (COI) studies. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-07147-z"},{"key":"ref_29","unstructured":"National Institute for Health and Care Excellence (NICE) (2022). Effective and Cost-Effective Interventions to Increase Frequent STI Testing in Very High Risk Groups: Reducing Sexually Transmitted Infections (STIs): Evidence Review D, NICE Evidence Reviews Collection."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Daponte, N., Valasoulis, G., Michail, G., Magaliou, I., Daponte, A.-I., Garas, A., Grivea, I., Bogdanos, D.P., and Daponte, A. (2023). HPV-Based Self-Sampling in Cervical Cancer Screening: An Updated Review of the Current Evidence in the Literature. Cancers, 15.","DOI":"10.3390\/cancers15061669"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.cmi.2019.09.006","article-title":"Primary HPV-based cervical cancer screening in Europe: Implementation status, challenges, and future plans","volume":"26","author":"Maver","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Banerjee, D., Mittal, S., Mandal, R., and Basu, P. (2022). Screening technologies for cervical cancer: Overview. Cytojournal, 19.","DOI":"10.25259\/CMAS_03_04_2021"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Del Romero, J., Guill\u00e9n, S.M., Rodr\u00edguez-Artalejo, F., Ruiz-Galiana, J., Cant\u00f3n, R., Ramos, P.D.L., Garc\u00eda-Botella, A., Garc\u00eda-Lled\u00f3, A., Hern\u00e1ndez-Sampelayo, T., and G\u00f3mez-Pav\u00f3n, J. (2023). Sexually transmitted infections in Spain: Current status. Rev. Espa\u00f1ola Quimioter., 36.","DOI":"10.37201\/req\/038.2023"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Luvi\u00e1n-Morales, J., Guti\u00e9rrez-Enr\u00edquez, S.O., Granados-Garc\u00eda, V., and Torres-Poveda, K. (2024). Risk factors for the development of cervical cancer: Analysis of the evidence. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1378549"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Fashedemi, O., Ozoemena, O.C., Peteni, S., Haruna, A.B., Shai, L.J., Chen, A., Rawson, F., Cruickshank, M.E., Grant, D., and Ola, O. (2024). Advances in human papillomavirus detection for cervical cancer screening and diagnosis: Challenges of conventional methods and opportunities for emergent tools. Anal. Methods.","DOI":"10.1039\/D4AY01921K"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e1544","DOI":"10.1016\/S2214-109X(24)00266-3","article-title":"WHO global research priorities for sexually transmitted infections","volume":"12","author":"Gottlieb","year":"2024","journal-title":"Lancet Glob. Health"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"G\u0142owienka-Stodolak, M., Bagi\u0144ska-Drabiuk, K., Szubert, S., Hennig, E.E., Horala, A., D\u0105browska, M., Micek, M., Ciebiera, M., and Zeber-Lubecka, N. (2024). Human Papillomavirus Infections and the Role Played by Cervical and Cervico-Vaginal Microbiota-Evidence from Next-Generation Sequencing Studies. Cancers, 16.","DOI":"10.3390\/cancers16020399"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Nguyen, H.D.T., Le, T.M., Lee, E., Lee, D., Choi, Y., Cho, J., Park, N.J.-Y., Chong, G.O., Seo, I., and Han, H.S. (2023). Relationship between Human Papillomavirus Status and the Cervicovaginal Microbiome in Cervical Cancer. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061417"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Huang, R., Liu, Z., Sun, T., and Zhu, L. (2024). Cervicovaginal microbiome, high-risk HPV infection and cervical cancer: Mechanisms and therapeutic potential. Microbiol. Res., 287.","DOI":"10.1016\/j.micres.2024.127857"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Fong Amaris, W.M., de Assump\u00e7\u00e3o, P.P., Valadares, L.J., and Moreira, F.C. (2024). Microbiota changes: The unseen players in cervical cancer progression. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1352778"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/2\/247\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:31:33Z","timestamp":1760027493000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/2\/247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["v17020247"],"URL":"https:\/\/doi.org\/10.3390\/v17020247","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,11]]}}}