Anal High-risk HPV and Liquid-based Cytology of Immunocompetent Brazilian Women with Genital High-risk HPV

Abstract

Objective The purpose of this study was to compare the frequency of the occurrence of high-risk human papillomavirus (HPV) and abnormal anal cytology in immunocompetent women with and without HPV-induced genital lesions. Methods This analytical cross-sectional, observational study was conducted between July 2017 and December 2018 in a specialized outpatient clinic of a tertiary hospital in Fortaleza, CE. Fifty-seven immunocompetent women with and without genital intraepithelial lesions were assessed; they were divided into two groups: group 1 was comprised of women with HPV-associated genital lesions (n = 26), and group 2 was comprised of those without HPV-associated genital lesions (n = 31). Samples for liquid-based cytology and high-risk DNA-HPV polymerase chain reaction real-time tests were collected from the cervix and anus. All cases were evaluated using high-resolution anoscopy; biopsies were performed when required. The Fisher exact and chi-squared tests were applied for consolidated data in the contingency table, and the Student t-test and Mann-Whitney U-test for independent variables. Results Anal high-risk HPV infections were more frequent in group 1 (odds ratio [OR], 4.95; 95% confidence interval [CI], 1.34–18.3; p = 0.012), along with concomitant high-risk HPV infections in the uterine cervix and the anus (OR 18.8; 95% CI, 2.20–160; p < 0.001). The incidence of high-risk cervical HPV infection was associated with high-risk anal HPV infection (OR, 4.95; 95% CI, 1.34–18.3; p = 0.012). There was no statistical difference concerning abnormal anal cytology or anoscopy between the groups, and no anal intraepithelial lesion was found in either group. Conclusion Immunocompetent women with HPV-associated genital lesions and high-risk cervical HPV were more likely to have high-risk anal HPV.

Diversity of Anal HPV and Non-HPV Sexually Transmitted Infections and Concordance with Genital Infections in HIV-Infected and HIV-Uninfected Women in the Tapajós Region, Amazon, Brazil

“…These findings corroborate the hypothesis that the transmission of HPV between the anus and cervix and vice versa is common in women [ 3 ], and there is a high risk of acquiring an anal HPV infection after cervical infection with HPV of the same genotype, which can occur independently of anal sex intercourse [ 19 , 20 ]. Cervical hrHPV infection is a risk factor for acquiring anal hrHPV infection in women with or without cervical intraepithelial lesions, although the prevalence of anal and cervical hrHPV infection identified in this study was very similar, being 42.9% and 47.9% for HIV-uninfected women and 75.0% and 77.5% for HIV-infected women, respectively [ 21 , 22 ].…”

Conhecimento para apoio aos profissionais responsáveis pelo diagnóstico de citologia anal: revisão narrativa e interpretação de critérios citomorfológicos

“…O diagnóstico precoce prevê a abordagem de pessoas com sinais e/ou sintomas da doença, impedindo a progressão para o câncer, e, assim, conduzir as pessoas ao tratamento mais adequado. Mas o rastreio pode ser realizado independente de sintomas e os grupos a serem rastreados ainda precisam ser definidos 3,15,16,17 .…”