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Urethritis (urinary tract infection) and HPV
In one study of chronic urethritis, HPV was detected in 31% of specimens positive for two or more infectious agents. In these cases it is quite likely that HPV plays a significant role. HPV may create an environment that encourages the persistence of other bacterial infectious agents such as Chlamydia, Mycoplasma, and Ureaplasma.
Minerva Urol Nefrol 1998 Dec;50(4):225-31:
Simultaneous detection of HPV and other sexually transmitted agents in chronic urethritis.
Chiarini F, Pisani S, Gallinelli C, Papi E, Seganti L, Degener AM, Pierangeli A, Gentile V, Brunori S, Di Silverio F. Microbiology Institute, School of Medicine, University of Rome La Sapienza.
“Background: Many pathogens may be responsible of Non Gonococcal Urethritis (NGU) with the possible occurrence of symptomatic and asymptomatic mixed viral and bacterial infections. In particular, genital papillomaviruses (HPVs) have been searched since they are linked to both benign and malignant lesions of the penis and urethra and the presence of a potential male carried state has received limited scrutiny while the screening of sexually active females has received substantial attention.
Methods: In male patients affected by chronic NGU, the presence of DNA of Chlamydia trachomatis, herpes simplex virus (HSV) type 1 and 2 and human papillomaviruses by PCR and the occurrence of Gram positive and Gram negative micro-organisms, of Mycoplasma hominis and Ureaplasma urealyticum, by conventional cultural methods have been investigated.
Results: Results obtained indicated a high percentage of mixed infections, up to 36%. Genital HPV DNA was detected in 31% of specimens positive for two or more agents, and HSV DNA was detected in 10% of studied population.
Conclusions: The concomitant presence of different infectious agents could determine latent, sub-clinical or chronic infections with periodic reactivation. In particular results suggest that HPV and HSV may stimulate cytokine production which can up regulate the expression of other infectious agents and may be responsible for latent chlamydial infections characterized by the persistence of this micro-organism in an altered form, viable but in a culture negative state. Therefore an increased awareness of mixed infections is relevant to define the management and treatment of chronic urethritis."
In all cases of chronic urethritis, a Digene test should be performed on a cervical swab and a urethral swab to look for the common HPV types. However, even with a negative Digene test, immune support should be considered in order to protect against possible HPV types which are not screened by the Digene test.