31 The prevalence and risk factors of anal human papillomavirus infection in high-grade cervical intraepithelial neoplasia patients

Abstract

Introduction and aims of the study: Cervical and anal cancers are the most common HPV-associated malignancies in women. Some studies suggest that high-risk cervical dysplasia (HRCD) patients have an increased risk for anal HPV-infection and anal high-grade dysplasia, however, this association is not well established. The aim of the study was to determine the incidence and to identify the possible risk factors (RF) of anal HPV infection in HRCD-patients. Methods: This was a cross-sectional study conducted in the Gynaecological department of Riga East Clinical University Hospital, involving 25 HRCD (CIN2+) patients with planned cervical excision. Following certain algorithms two separate tissue samples from the rectum and cervix were obtained and patients were asked to fill out the questionnaire about different RF. Samples were sent to the Central laboratory and analysed using HPV RT-PCR method. The high-risk HPV analysis of 14 genotypes were performed. The study was approved by the Ethics Committee of Rīga Stradiņš University. The data was processed using IBM SPSS Statistics 26. Results: Of all patients in this study 92% had positive high-risk HPV in the cervix and 36% had high-risk anal HPV infection. There were noticeable differences between anal HPV-positive and negative groups regarding different RF – the mean age of coitarche - 16.9±1.5 and 18±2.5, the mean number of sexual partners – 7.63±5.5 and 5.5±3.3, the mean number of cervical HPV types - 1.44±1.0 and 1.06±0.6, 33.3% and 12.5% had cervical carcinoma, respectively, and in both groups 33.3% have had anal sex, but the difference was statistically insignificant (p>0.05). Conclusions: In this study one-third of HRCD-patients were proven to have a high-risk anal HPV infection. More extensive studies should be carried out to evaluate anal HPV infection and its RF, subsequent premalignant changes of the anal region and the benefit from anal HPV screening in HRCD-patients.