title: High-risk human papillomavirus infection of the genital tract of women with a previous history or current high-grade vulvar intraepithelial neoplasia.
abstract: Human papillomavirus (HPV) infection is associated with high-grade vulvar intraepithelial neoplasia (VIN-3). The prevalence of anogenital HPV infection in women with previously treated VIN-3 has not been documented yet. This cross-sectional study compared high-risk HPV DNA detection rates in women with past (n = 30) and current (n = 22) VIN-3 to those without current or past VIN (n = 86). HPV DNA was detected in vulvar and cervical samples with Hybrid Capture 2 (HC-2). Smoking was associated in multivariate analysis with current VIN-3 (odds ratio (OR) 8.3, 95% confidence interval (CI) 2.0-8.2) and any VIN-3 history (OR 6.5, 95% CI 2.5-16.5). High-risk HPV DNA was found on the vulva of 64%, 33%, and 20% of women with current VIN-3, past VIN-3, and without previous or current VIN, respectively. After controlling for age and smoking, high-risk HPV vulvar infection was associated with cervical high-risk HPV infection (OR 8.6, 95% CI 2.8-26.5; P = 0.001). After controlling for age, HPV infection was more often multifocal in women with current VIN-3 compared to women with previous but no current VIN-3 lesion (OR 17.6, 95% CI 1.4-227.2). Multifocal vulvar HPV infection was detected in women with previous or active VIN-3. Longitudinal studies are required to determine if the multifocality of HPV infection on the vulva could explain the high recurrence rate of VIN-3.
authors.affiliation: Département d'Obstétrique, Pathologie et Microbiologie-Infectiologie, Hôpital Notre Dame-Centre Hospitalier de l'Université de Montréal, CHUM, Montréal, Québec, Canada.
authors.forename: Frederic
authors.initials: F
authors.lastname: Goffin
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Mayrand
authors.forename: Philippe
authors.initials: P
authors.lastname: Gauthier
authors.forename: A
authors.initials: A
authors.lastname: Alobaid
authors.forename: Christian
authors.initials: C
authors.lastname: Lussier
authors.forename: Diane
authors.initials: D
authors.lastname: Provencher
authors.forename: Pierre
authors.initials: P
authors.lastname: Drouin
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Franco
authors.forename: François
authors.initials: F
authors.lastname: Coutlée
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002584:Cervix Uteri / Q000821:virology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D014844:Vulva / Q000821:virology; D014846:Vulvar Neoplasms / Q000821:virology*
chemical_list: D004279:DNA, Viral