engleski

Human papillomavirus (HPV) risk group patterns, temporal dynamics and relationship with abnormal cervical cytology findings in women during a 10- year period: elucidating the significance of low- risk/high-risk co-infection

Background and Objectives Human papillomavirus (HPV) represents a major risk factor for cervical dysplasia and invasive cervical cancer. Although most efforts are reasonably concentrated on high- risk HPV, we aimed to determine the overall and risk group-specific HPV patterns in a subset of women, as well as to evaluate the correlation of low-risk and/or high-risk HPV positivity with abnormal cervical cytological findings. Methods A convenience sample of 751 women (aged 18-67) visiting an outpatient clinic were simultaneously subjected to HPV DNA testing and cervical cytology evaluation during a 10-year period in Zagreb, Croatia. Specimens were screened with Digene HC2 HPV DNA Test (Qiagen Corporation, USA) for both low-risk and high-risk HPV risk groups. The cytology was reported using Bethesda system / “Zagreb 2002” classification. Statistical significance was set at p<0.05. Results In our cohort the overall HPV prevalence was 48.6%, and highest infection burden was in the 18- 30 age group (p=0.046). A decrease in low-risk and high- risk mono- positivity has been observed over the 10-year period ; conversely, there was a significant increase in low-risk/high-risk co- positivity (p=0.007). A co-infection with both low-risk and high-risk HPV prompted a compounding effect which increased the occurrence of abnormal cells and low grade squamous intraepithelial lesions (LSIL ; CIN I). Conclusions Our results have demonstrated that low-risk HPV has the propensity to act as a co-factor in the development of cytological abnormalities and LSIL, but not high grade squamous intraepithelial lesions (HSIL). If further longitudinal studies corroborate these findings, HPV testing that includes a broader gamut of HPV types may be justified.

human papillomavirus ; women ; low-risk/high-risk

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