The association among cervical, anal, and oral HPV infections in high-risk and low-risk women

Abstract

The association among cervical, anal, and oral HPV infections in high-risk and low-risk women Borek Sehnala, Michal Zikana, Monika Nipcovaa, Ladislav Dusekb, David Cibulac, Jiri Slamac,* a First Faculty of Medicine, Charles University and Hospital Na Bulovce, Department of Gynaecology and Obstetrics, Budinova 2, Praha 8, 180 81, Prague, Czech Republic b Institute of Biostatistics and Analyses, Masaryk University, Kamenice 3, 625 00, Brno, Czech Republic c First Faculty of Medicine, Charles University and General University Hospital, Gynaecologic Oncology Centre, Apolinarska 18, Praha 2, 128 51, Prague, Czech Republic A R T I C L E I N F O Article history: Received 21 March 2019 Received in revised form 21 May 2019 Accepted 1 June 2019 Available online 19 June 2019 Keywords: Human papillomavirus (HPV) Cervical HPV infection Anal HPV infection Oral HPV infection Concurrent HPV infection A B S T R A C T Objective: The human papillomavirus (HPV) can cause premalignant and malignant tumors in the anogenital and oropharyngeal regions. The aim of this study was to describe the association in the prevalence of cervical, anal, and oral HPV infections in high-risk patients with biopsy-confirmed highgrade cervical lesion compared to low-risk women. Study Design: A total of 718 immunocompetent womenwere enrolled in the study. The high-risk (HR) group consisted of 473 patients with biopsy-confirmed high-grade cervical lesion while the low-risk (LR) group consisted of other 245 women. All participants completed an anonymous self-administered questionnaire and were subjected to cervical, anal, and oral HPV genotyping using the Linear array HPV test. Results: A total of 81.4% women were infected in the cervix, 43.3% in the anus, and 2.7% in the oral cavity in the HR group in comparison with only 26.9%, 24.5%, and 1.4% in the low-risk LR group, respectively. The cervical and anal HPV infections were much more frequent in the HR patients (p < 0.001); the difference in the oral HPV prevalence was not significant (p = 0.511) between groups. Concurrent cervical-anal infection was observed in 39.3% of HR women and in 8.3% of the LR patients (p < 0.001) and it significantly increased with the grade of cervical lesion (ptrend<0.001). The higher prevalence of concurrent cervical-oral, analoral, and cervical-anal-oral infections in HR women was statistically not significant according to the generally small oral HPV prevalence. Conclusions: All HPV infections occurred more often in HR than in LR women but not all results were statistically significant. The genotype HPV 16 was found in approximately half of all infections at all sites.