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.

Resumo

Objetivo O objetivo deste estudo foi comparar a frequência de papilomavírus humano (HPV) de alto risco e citologia anal anormal em mulheres imunocompetentes com e sem lesões genitais induzidas por HPV.

Métodos Este estudo transversal analítico e observacional foi realizado entre julho de 2017 e dezembro de 2018 em um ambulatório especializado de um hospital terciário em Fortaleza, CE. Cinquenta e sete mulheres imunocompetentes com e sem lesões intraepiteliais genitais foram avaliadas. Foram divididas em dois grupos: grupo 1, composto por mulheres com lesões genitais associadas ao HPV (n = 26) e grupo 2, composto por mulheres sem lesões genitais associadas ao HPV (n = 31). Amostras para citologia em meio líquido e testes de reação em cadeia da polimerase em tempo real para DNA-HPV de alto risco foram coletadas do colo do útero e do ânus. Todos os casos foram avaliados por anuscopia de alta resolução; sendo realizada biópsia quando necessária. Os testes exatos de Fisher e qui-quadrado foram aplicados para dados consolidados na tabela de contingência; o teste t de Student e o teste U de Mann-Whitney foram aplicados para variáveis independentes.

Resultados As infecções anais por HPV de alto risco foram mais frequentes no grupo 1 (razão de chances [RC], 4,95; intervalo de confiança [IC] de 95%, 1,34–18,3; p = 0,012), assim como infecções concomitantes por HPV de alto risco em colo uterino e ânus (RC 18,8; IC de 95%, 2,20–160; p < 0,001). A incidência de infecção de HPV cervical de alto risco foi associada à infecção de HPV anal de alto risco (RC, 4,95; IC de 95%, 1,34–18,3; p = 0,012). Não houve diferença estatística em relação à citologia anal anormal ou anuscopia entre os grupos, e não houve caso de lesão intraepitelial anal em nenhum dos grupos.

Conclusão Mulheres imunocompetentes com lesões genitais associadas ao HPV e com HPV cervical de alto risco foram mais propensas a ter HPV anal de alto risco.

Keywords

cytology - papillomaviridae - colposcopy - anus neoplasm - polymerase chain reaction

Palavras-chave

citologia - papilomaviridae - colposcopia - neoplasias do ânus - reação em cadeia da polimerase

Contributions

All authors participated in the conception and design of the present study, analysis and interpretation of data, and draft or revision of the manuscript, and they have approved the manuscript as submitted. All the authors are responsible for the reported research.

Publication History

Received: 28 April 2021

Accepted: 11 November 2021

Article published online:
09 February 2022

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