Association of Chlamydia trachomatis Serostatus with HPV infection in women aged 16-64 years old living in metropolitan area of San Juan, Puerto Rico

Background and Objectives: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) are among the most common sexually transmitted infections world-wide. Recent studies suggest CT as a cofactor of persistence of HPV infection, however, these results remain inconclusive. The aim of this study is to examine the association of HPV antibodies in serum with CT antibodies among women aged 16-64 years living in the San Juan Metropolitan area of Puerto Rico. Methods: This is a secondary data analysis from a cross-sectional, population-based study of HPV infection in women from Puerto Rico (2010-2013) and from the serum repository of women who participated in the same cross-sectional study. A total of 530 (93.6%) women were eligible for this analysis.  Enzyme linked immunosorbent assays were used to detect serum antibodies to CT and HPV (-6, -11, -16 and -18). Multivariate logistic regression models were used to estimate the adjusted prevalence odds ratio (POR adjusted) in order to determine the magnitude of the association between HPV and CT serostatus, controlling for different demographics, sexual practice and lifestyles characteristics. Results: Overall, 97 (18.51%) of women were CT seropositive and 251 (47.0%) were HPV seropositive. After adjustment for age, education, and average of sexual partners per year, women seropositive for 2+ HPV types were 2-fold more likely to also be seropositive for CT (POR_adj= 1.91, 95% CI=1.15-3.22) when compared to women HPV seronegative. Meanwhile, no difference was observed in the likelihood of CT seropositivity between women seropositive to 1 HPV type as compared to those HPV seronegative (p>0.05). Conclusions: Results from this population-based sample of women aged 16-64 years in Puerto Rico suggest an association between CT and HPV seroprevalence in women seropositive for 2 or more HPV genotypes. Future longitudinal studies should further evaluate this association and investigate whether CT infection influences HPV acquisition and persistence in this population. Acknowledgements: This study was approved by the UPRMSC IRB (#A1810414) and was partially funded by NIAID Grant #: 1SC2AI090922-01.