Using a new HPV detection system in epidemiological research: change of views on cervical dyskaryosis?
The prevalence of human papillomavirus (HPV) rises with increasing histological severity of neoplasia, more cigarettes smoked per day and higher lifetime number of sexual partners in women with cervical dyskaryosis. Recently, the highly sensitive SPF10 primers and Inno-LiPA (line probe assay) HPV prototype research assay became available for the detection and typing of HPV.


BACKGROUND
using this system, we challenged the previously reported findings.


METHODS
the study group comprised 304 women referred because of abnormal pap smears in whom a histological diagnosis was made. Data on the lifetime number of sexual partners and smoking behaviour were obtained by questionnaire. HPV analysis was performed on cervical scrapes obtained at the enrollment visit.


RESULTS
oncogenic HPV was found in 288 (95%) women. A total of 86 (30%) out of these 288 women disclosed multiple types. HPV 16 occurred significantly less often in multiple infections than was expected on the basis of chance alone. The grade of neoplasia was significantly associated with the presence of oncogenic HPV, and this association depended on the presence of HPV type 16. No association was found between grade of neoplasia and the presence of multiple HPV types. Neither the lifetime number of sexual partners nor smoking were associated with oncogenic HPV, the five most frequent HPV types separately or the presence of multiple types.


CONCLUSIONS
we conclude that the association between the detection of HPV and the epidemiological risk factors, as found with the GP5/6 PCR in the past, could not be confirmed when using SPF10 PCR primers and LiPA HPV genotyping. We suggest that the number of sexual partners and smoking may be determinants of high HPV viral load rather than determinants of the presence of HPV per se.
Reesink-Peters
N
N
Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Burger
M P
MP
Kleter
B
B
Quint
W G
WG
Bossuyt
P M
PM
Adriaanse
A H
AH
D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods*; D012747:Sexual Partners; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology