Prevalence and clinical significance of Ureaplasma urealyticum and Mycoplasma hominis in the lower genital tract of HIV-1-infected women

Mycoplasma hominis and Ureaplasma urealyticum are frequently isolated from the cervical and vaginal tracts of HIV-negative asymptomatic women. Published data lack indisputable conclusions and doubts still exist as to whether these mycoplasmas are pathogens or mere co-factors associated with genital infections. We therefore conducted a surveillance study to investigate the prevalence of genital mycoplasmas in HIV-1 positive women (110 patients), attending the outpatient Infectious Diseases Clinic of our tertiary referral Hospital, by speculum examination, PAP test, endocervical and vaginal swabs obtained by gynaecologists. Ureaplasma urealyticum was isolated from the cervix of 45 women (41%). Mycoplasma hominis was recovered from 12 women (11%), in four of whom it was isolated at the same time from the vagina. PAP test results ruled out subclinical cervicitis in all women. Bacterial vaginosis, assessed by Amsel criteria and the Nugent score, was absent in all women. Our data show that the mycoplasmas in question are found in the lower genital tract of asymptomatic HIV-1-positive women at a frequency similar to that reported in the HIV-negative female population, and make a role for these microorganisms unlikely in the aetiology of cervico-vaginal infections also in this particular patient population.