title: The relationship between the cervical and anal HPV infection in women with cervical intraepithelial neoplasia.
abstract: BACKGROUND
  More than 90% of cases of anal cancers are caused by high-risk human papillomavirus (HR HPV) infection and a history of cervical intraepithelial neoplasia (CIN) is established as possible risk factor.
  
  
  OBJECTIVE
  To demonstrate relationship between anal and cervical HPV infection in women with different grades of CIN and microinvasive cervical cancer.
  
  
  METHODS
  A total of 272 women were enrolled in the study. The study group included 172 women who underwent conization for high-grade CIN or microinvasive cervical cancer. The control group consisted of 100 women with non-neoplastic gynecologic diseases or biopsy-confirmed CIN 1. All participants completed a questionnaire detailing their medical history and sexual risk factors and were subjected to anal and cervical HPV genotyping using Cobas and Lynear array HPV test.
  
  
  RESULTS
  Cervical, anal, and concurrent cervical and anal HPV infections were detected in 82.6%, 48.3% and 42.4% of women in the study group, and in 28.0%, 26.0% and 8.0% of women in the control group, respectively. The prevalence of the HR HPV genotypes was higher in the study group and significantly increased with the severity of cervical lesion. Concurrent infections of the cervix and anus occurred 5.3-fold more often in the study group than in the control group. Any contact with the anus was the only significant risk factor for development of concurrent HPV infection.
  
  
  CONCLUSIONS
  Concurrent anal and cervical HR HPV infection was found in nearly half of women with CIN 2+. The dominant genotype found in both anatomical locations was HPV 16. Any frequency and any type of contact with the anus were shown as the most important risk factor for concurrent HPV infection.
authors: Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic. Electronic address: boreksehnal@seznam.cz.
authors: Borek
authors: B
authors: Sehnal
authors: Institute of Biostatistics and Analyses, Masaryk University, Kamenice 3, Brno, 625 00, Czech Republic.
authors: Ladislav
authors: L
authors: Dusek
authors: General University Hospital and 1st School of Medicine, Gynaecologic Oncology Centre, Charles University, Apolinarska 18, Prague 2, 128 51, Czech Republic.
authors: David
authors: D
authors: Cibula
authors: General University Hospital and 1st School of Medicine, Institute of Medical Biochemistry and Laboratory Diagnostics, Charles University, U Nemocnice 2, Prague 2, 128 08, Czech Republic.
authors: Tomas
authors: T
authors: Zima
authors: Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic.
authors: Michael
authors: M
authors: Halaska
authors: Hospital Na Bulovce and 1st School of Medicine, Charles University, Department of Gynaecology and Obstetrics, Budinova 2, Prague 8, 180 81, Czech Republic.
authors: Daniel
authors: D
authors: Driak
authors: General University Hospital and 1st School of Medicine, Gynaecologic Oncology Centre, Charles University, Apolinarska 18, Prague 2, 128 51, Czech Republic.
authors: Jiri
authors: J
authors: Slama
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000821:virology*; D002584:Cervix Uteri / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D017720:Molecular Epidemiology; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000821:virology*
keywords: AIN; AIS; ASC-H; Anal cancer; Anal infection; CIN; CIN 2+; COC; Cervical infection; DNA; HIV; HPV; HR; HRT; HSIL; IUD; LR; OR; PCR; adenocarcinoma in situ; anal intraepithelial neoplasia; atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion; cervical intraepithelial neoplasia; combined oral contraception; deoxyribonucleic acid; high-grade squamous intraepithelial lesion; high-gradeCIN or microinvasive cervical cancer; high-risk; hormone replacement therapy; human immunodeficiency virus; human papillomavirus; intrauterine device; low-risk; odd ratio; polymerase chain reaction