NEW YORK (Reuters Health) - Women with antibodies to chlamydial heat shock protein 60-1 (HSP60-1), a marker of persistent chlamydial infection, are at increased risk for developing cervical cancer, new research suggests.

These findings, coupled with other emerging data suggest that "cervical cancer should be listed as one of the potential long-term sequelae of genital chlamydial infection," lead investigator Dr. Jorma Paavonen from the University of Helsinki in Finland told Reuters Health.

Dr. Paavonen and colleagues identified 178 women with invasive cervical cancer and matched each case patient to three cancer-free controls. They used enzyme-linked immunosorbent assay to measure serum antibodies to the chlamydial HSP60 in cases and controls. For cases, they analyzed the earliest pre-diagnostic serum sample.

They found that the presence of antibodies to chlamydial HSP60-1 increased the risk of cervical squamous cell carcinoma, especially among cases with a long lag time (>3.5 years) between serum sampling and cervical cancer diagnosis (odds ratio 2.4).

Antibodies to the other two types of chlamydial HSP60 -- HSP60-2 and HSP60-3 -- were not associated with cervical cancer risk, the team reports in the November issue of the American Journal of Obstetrics and Gynecology.

While persistent infection with one or more high-risk HPV types causes the vast majority of cases of cervical cancer, emerging evidence suggests that Chlamydia trachomatis is an important cofactor. (See Reuters Health report October 3, 2002.)

"Chlamydia trachomatis is an immunomodulator, which causes chronic inflammation and may alter the host immune response, and ultimately inhibit spontaneous clearance of HPV," Dr. Paavonen said.

The current study findings "further emphasize the importance of sexual health education in primary prevention and Chlamydia screening programs in the secondary prevention of chlamydial infections, particularly since the vast majority of genital chlamydial infections are asymptomatic," he added.

Am J Obstet Gynecol 2003;189:1287-1292

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