Sexually transmitted diseases in adult, non-pregnant women.

Most of the publications reviewed focus on human papillomavirus (HPV), and a small proportion on herpes simplex virus (HSV), Chlamydia trachomatis, as well as the syndromes of pelvic inflammatory disease and bacterial vaginosis. The present hypothesis associates cervical intraepithelial neoplasia (CIN)-1 with high oncogenic risk HPV types in less than 30% of cases; whereby CIN-2 and CIN-3 are associated with a 90% risk. However, on the basis of HPV types, four categories ['low risk' (HPV 6/11, 42, 43, 44); 'intermediate risk' (HPV 31, 33, 35, 51, 52, 58); 'high risk/HPV 16'; and 'high risk/HPV 18'] for the associated risk for a high-grade lesion or an invasive cancer can also be defined. In practice it appears efficient to re-evaluate patients with oncogenic types in association with low-grade cytology, as well as women with high-grade cytology or suspicious colposcopy in narrow intervals. Several reports have suggested that HPV genital infections are multifocal; however, HPV DNA was also found in the lymph nodes and in the granulocytes of women with cervical cancer, in ovarian and endometrial tissue, in tumours of the urinary bladder, and in mammary ductal carcinoma.