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Epidemiological characteristics of women with high grade CIN who do and do not have human papillomavirus
Author(s) -
Tabrizi Sepehr N.,
Fairley Christopher K.,
Chen Shujun,
Borg Anthony J.,
Baghurst Peter,
Quit Michael A.,
Garland Suzanne M.
Publication year - 1999
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1999.tb08239.x
Subject(s) - human papillomavirus , cervical intraepithelial neoplasia , cervical cancer , epidemiology , medicine , dysplasia , polymerase chain reaction , hpv infection , human leukocyte antigen , biopsy , gynecology , cancer , antigen , immunology , biology , gene , genetics
Objective Human papillomavirus infection is an important aetiological agent associated with the devel‐ opment of cervical neoplasia. However, even with the most sensitive methods of detection, human papillomavirus DNA has been detected in only 90% of cases of cervical cancer and between 80%‐90% of cases of dysplasia. This study aimed to determine if there are epidemiological differences between women who are positive or negative for human papillomavirus. with high grade cervical intraepithelial neoplasia (CIN). Design Four hundred and sixty women with CIN 11 and 111 lesions were studied. To ensure optimal detection of human papillomavirus DNA, two specimens (i.e. tampon and cervical biopsy) were collected from each woman and tested by three techniques: L1 ‐polymerase chain reaction, E6–PCR and low stringency Southern blotting. A detailed questionnaire was completed and blood sample collected for determination of serum levels of beta‐carotene, vitamin A and E from each patient. Human leucocyte antigen (HLA)‐DQB 1 alleles were also compared between the groups of women who were positive or negative for human papillomavirus. Results Overall, human papillomavirus DNA analysis was positive in 411 women (89%). Age, number of sexual partners in the last 12 months, past pregnancy and marital status werc associated with human papillomavirus detection in the crude analysis. However, in the adjusted analysis no cpidemi‐ ological features remained significantly differcnt between the human papillomavirus positive and negative patients. Moreover, examination of vitamin A, E and beta‐carotene levels did not show a significant difference between the two groups of patients. However, in the HLA‐DQBI allele profile a significantly higher proportion of women who were negative for human papillomavirus had DQB1 * 0201, * 0603 and * 0604 ( P = 0.05.0.001,0.03 , respectively). Conclusion We did not find a significant differcnce in epidemiological factors between women with human papillomavirus positive and negative high grade CIN. However differences between the frequency of thrcc HLA DQB1 alleles suggest that women with these allele profiles have a higher chance of clearing human papillomavirus, without affecting their chance of developing dysplasia.