Anal human papillomavirus DNA in women at a colposcopy clinic.
OBJECTIVE
To describe the type-specific prevalence of anal and cervical human papillomavirus (HPV) infections and the cytology in HIV-negative women without a history of cervical cancer, attending a colposcopy clinic. To examine if an HPV positive anal smear is related to anal pathology and consequently indicative for further examinations (high resolution anoscopy, anal biopsy).


METHODS
From 149 consecutive women an anal swab and a cervical swab were taken, using the Cervex-Brush. The presence of 18 different HPV genotypes was determined using TaqMan-based real-time quantitative PCR targeting type-specific sequences of viral genes. From the fluid containing the cellular material, a liquid-based cytology sample was prepared of both collections with the robotic BD PrepStain Slide Processor. All slides were pre-screened by BD FocalPoint system and categorized from quintiles 1 to 5 and afterwards screened using targeted microscopic interpretation of selected suspicious fields using FocalPoint guided screening review stations. The 2001 Bethesda System Terminology was used for the anal slides.


RESULTS
Ninety-six anal samples and all 149 cervical samples were adequate. Overall presence of HPV in the anus was 56.3% and in the cervix 53.7%. Overall, cytological abnormalities were found in 10.8% of anal smears and in 32.8% of cervical smears. HPV genotypes were identified in 47 samples on both sites: partial or complete concordance was found in 85.1%. HPV types 6, 16 and 18 were found in 27.9% and in 26.6% of the anal and cervical samples, respectively. The top three HPV types in the anus were 16, 51 and 39; in the cervix 16, 39, 51 and 56 (a shared 3(rd) place). HPV type 11 was not found.


CONCLUSIONS
The presence of HPV genotypes is clearly multifocal in this study population of women attending a colposcopy clinic, with high concordance of genotypes. The number of anal HPV infections is high. Although cytological abnormalities are rare, the presence of HPV may lead to anal lesions later in life. From this perspective, complementary medical history and clinical examination of the anal region are advised.
Radboud University Nijmegen, Medical Centre, Dept. of Urology, Geert Grooteplein Zuid 10, Internal Route 659, 6525 GA Nijmegen, The Netherlands. k.dhauwers@uro.umcn.nl
Kathleen W M
KW
D'Hauwers
Tine
T
Cornelissen
Christophe E
CE
Depuydt
Johannes
J
Bogers
A Rogier T
AR
Donders
Elke
E
Leuridan
Pierre
P
Van Damme
Wiebren A A
WA
Tjalma
D000328:Adult; D001003:Anal Canal / Q000821:virology*; D002584:Cervix Uteri / Q000821:virology; D003127:Colposcopy; D003584:Cytological Techniques; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D015995:Prevalence; D014626:Vaginal Smears
D004279:DNA, Viral