HPV prevalence, risk factors, sensibility for HPV test in women with higher risk for HSIL

Joaquim Neves (PT), Alexandra Meira (PT), Ana Otilia Costa (PT), Margarida Mendes Almeida (PT), Carlos Calhaz Jorge (PT), Maria Valente Pulido Valente (PT)

[Neves] Hospital Santa Maria - Lisboa, [Meira] Hospital Santa Maria - Lisboa, [Otilia Costa] Hospital Santa Maria - Lisboa, [Mendes Almeida] Hospital Santa Maria - Lisboa, [ Calhaz Jorge] Hospital Santa Maria - Lisboa, [Pulido Valente]

Context: HPV persistent infection is the major cause for cervical cancer and precursor lesions. Women carriers of high risk HPV (HPV-HR) have a significant risk for neoplasia. Objective: To find HPV-HR prevalence, altered cytology, risk factors associated, and sensibility for HPV-HR test using HSIL on biopsy as standard. Methods: Retrospective study (November 2012 to June 2016). Adjuvant DNA HPV-HR test was performed (isolated HPV16 and 18 detection and 12 others HPV). Data were analyzed considering HPV-HR prevalence, altered cytology prevalence, age, parity, age at first intercourse, multiplicity of sexual partners, hormonal contraception use (HC) and smoking habits (SH). Patients: Women between 25 and 65 years included in an opportunistic screening for cervical cancer. Results and Conclusions: 2457 were included with 48 years as median age. HPV-AR positive was found in 255 women (10.3%) with predominance for HPV-HR others rather than 16 and 18. 145 women with negative Pap smear presented HPV-HR positive (16 with HPV16; 6 with HPV18; 122 with others HPV than 16 and 18; 18 with mixed HPV-HR). Altered cytology was referred in 139 cases (5.6%): 67 with LSIL (HPV16 in 16 cases and HPV18 in 6 cases), 61 with HSIL (HPV16 in 40 women, HPV18 in 6 cases and HPV others in 15 cases), 10 with ASC-H (7 cases with HPV16 and 3 cases for HPV others) and one AGC case with HPV16 positive. HPV-HR positive were more frequent in women between 30 to 39 years old (p≤0,001). HPV-HR positive were related with SH (36.3% vs 25.9% p=0.029), HC use (38.6% vs 30% p=0.029), higher number of sexual partners (3 vs 2 p≤0.001) and earlier starting of sexual activity (18 vs 19 p=0.01). In 61 women with higher risk for HSIL in biopsy, DNA HPV test alone have an elevated sensibility (0.96) against (0.80) for cytology. Our results are compared with recent published data and with our previous preliminary analyses, reinforcing HPV prevalence distribution (more case for HPV others), risk factors as SH, HC and sexual behavior, and confirming high sensibility for DNA HPV test concerning HSIL diagnosis in biopsy.