Presença de Chlamydia trachomatis em cânceres associados ao HPV: uma Revisão Sistemática

Abstract

Human papillomavirus (HPV) is one of the main etiological agents of cervical cancer (CC), whose malignant transformation involves persistent infection and integration of viral DNA into the host genome. However, carcinogenesis also requires the involvement of other infectious agents, such as Chlamydia trachomatis (CT), a sexually transmitted bacterium associated with chronic inflammation and viral persistence in cancer development. Although most studies focus on CC, it is important to investigate the presence of CT in other HPV-associated neoplasms. Therefore, this study aimed to summarize the main studies that investigated the presence of CT in samples of cancers associated with HPV. A systematic review of the literature was conducted according to PRISMA guidelines, with the protocol registered in PROSPERO. Searches were carried out in the PubMed, Science Direct, and LILACS databases, using specific descriptors based on MeSH and DeCS terms. The risk of bias in the included studies was assessed using the JBI platform. A total of 1,748 studies were identified, of which 12 met the eligibility criteria and were included: 8 case-control, 2 cohort, and 2 cross-sectional studies. Seven studies addressed CT in CC, with eight reporting a statistically significant association. Vulvar and anal neoplasms were cited in two and one study, respectively, with statistical significance found in only one study on vulvar cancer. CT prevalence ranged from 1.7% to 65%. The most commonly used diagnostic techniques were ELISA and MIF on liquid and cervical smear samples, and PCR, including nested and multiplex variants. Nine studies analyzed CT/HPV coinfection, with prevalence ranging from 28.9% to 97%. The findings reinforce that CT may increase the risk of cervical cancer, especially in cases of coinfection with HPV. Further studies are needed to explore this association in other HPV-related malignancies