Anal study in immunocompetent women with human papillomavirus related lower genital tract pathology

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 211; pp. 15 - 20
• Main Authors: Donaire, Concepción, Reillo, Marcos, Martínez-Escoriza, Juan C, López-Fernández, José A
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2017
• Subjects: Adult; Aged; Anal Canal - pathology; Anal Canal - virology; Anal dysplasia; Anus Neoplasms; Cervical dysplasia; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; Female; HPV types; Humans; Middle Aged; Obstetrics and Gynecology; Papillomaviridae - isolation & purification; Papillomavirus Infections - pathology; Papillomavirus Infections - virology; Prospective Studies; Sexual Behavior; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Young Adult; Cervical dysplasia; HPV types; Anal dysplasia
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2017.01.023

Abstract Objetive To estimate the prevalence of anal dysplasia in immunocompetent women with cervical intraepithelial dysplasia. Study design We did a prospective cohort study, in which we enrolled 166 women with gynecological pathology related to human papilloma virus (HPV) infection. All patients underwent an anal cytology and HPV detection. Statistical analysis with a 95% confidence interval was used for prevalence calculations. A Χ2 test and Fisher’s exact one were used to determine differences between groups of qualitative variables. Differences between normally distributed and non-normally distributed groups in quantitative variables were accounted for using Student’s t -test or Mann-Whitney’s U test, respectively. Results Out of the 166 patients studied, high risk HPV in the anal canal was detected in 107 (64.46%) cases. The most prevalent genotype observed was non 16/18 high risk HPV, present in 54 (50.47%) patients. There was no a significant association with smoking, use of condom, anal intercourse, or anal benign pathology. However, a significant correlation between the presence of high risk HPV in the anal canal and the antecedent of condylomas was observed (p = 0.047) (CI95%: 1.00%–12.58%). Women with cervical intraepithelial neoplasia (CIN) grade 1 had a significantly increased presence of high risk HPV in the anal canal (p = 0.044). Out of the 166 women, 6 (3.61%) had abnormal anal cytology results, and were referred to high-resolution anoscopy. Anal biopsy was performed in these six cases. In 2 patients the biopsy reported low-grade Anal Intraepithelial Neoplasia: 1.20% (0.15%–4.28%). Conclusions Women with cervical intraepithelial dysplasia have 1.20% prevalence of anal intraepithelial neoplasia, so that it does not seem necessary to screen this population.