The role of multiple high-risk human papillomavirus infections for cervical biopsies and findings in colposcopic procedures

• Published in: Journal of the Turkish German Gynecological Association Vol. 24; no. 2; pp. 101 - 108
• Main Authors: Akış, Serkan, Öztürk, Uğur Kemal, Keleş, Esra, Alınca, Cihat Murat, Kabaca, Canan, Api, Murat
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Publishing House 07.06.2023; Galenos Publishing
• Subjects: Biopsy; Human papillomavirus; Original Investigation; Patients; colposcopy; Cervical dysplasia; cervical intraepithelial neoplasia; HPV; multiple HPV infection
• ISSN: 1309-0399; 1309-0380
• DOI: 10.4274/jtgga.galenos.2023.2022-8-10

The clinical outcome of high-risk HPV (hr-HPV) infection varies according to genotype(s). Patients may harbor either one single hr-HPV (s-HPV) or multiple HPV (m-HPV) genotypes. Recently, the relationship between m-HPV infections and high-grade dysplasia has been investigated, and controversial results have been obtained. Therefore, the clinical significance of m-HPV is not clear. This study aimed to evaluate which group is associated with higher grade dysplasia by analyzing colposcopic punch biopsies. A total of 690 patients who were scheduled for a diagnostic excisional procedure between April 2016 and January 2019 due to the detection of high-grade cervical intraepithelial neoplasia (CIN 2/3) in colposcopy were included. Patients who were not scheduled for colposcopic examination or cervical punch biopsy, or who were scheduled for an excisional procedure due to smear-biopsy incompatibility or persistent low-grade dysplasia were excluded. Patients with a negative HPV test and an unknown HPV genotype were also excluded. Among the patients scheduled for excision (n=404), 74.5% had a s-HPV and 25.5% had a m-HPV infection. The proportion of CIN 1, 2 and 3 per patient in the m-HPV group was significantly higher than the s-HPV group (p=0.017). When this analysis was made for the number of CIN 2+3 per patient in the s-HPV and m-HPV groups, it was 1.29 (389/301) and 1.36 (140/103), respectively, and no difference was found (p=0.491). Patients in the m-HPV group, who underwent more colposcopic cervical biopsies, had higher numbers of CIN lesions, regardless of age and cytology results.