Synchronous anal HPV Infection in Patients with HPV‑Related Gynaecological Diseases: A Prospective Study

<p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><strong>ABSTRACT</strong></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><strong>Introduction</strong></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><span lang="EN-US">Patients with human papillomavirus-related gynaecological diseases (HPV-RGD) are at risk of synchronous HPV infections in other regions, including the anal canal. The primary objective was to examine the prevalence of anal HPV in patients treated for HPV-RGD. Secondary objectives were to test HPV types distribution and the risk of anal infection depending on the HPV-RGD localization.</span></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><strong>Methods</strong></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt">A prospective study was conducted with two groups: the research group, histologically confirmed HPV-RGD, and the control group, gynaecological diseases not related to HPV (all human immunodeficiency virus (HIV) negative). The swabs for HPV genotyping and liquid cytology (Anyplex II HPV HR Detection test) were collected from the anal canal (both groups) and the area of gynaecological disease (research group).</p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><span lang="EN-US"></span><br /></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><strong><span lang="EN-US">Results</span></strong></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><span lang="EN-US">The prevalence of  anal HPV infection in the research group (n&#61;130) was significantly higher than in the control group (n&#61;100) (</span><span lang="EN-GB">64.62</span><span lang="EN-US">% vs. 11%, p&lt;0.05). All patients with vulva cancer (n&#61;7) and vaginal precancer (n&#61;6) exhibited anal HPV infection (p&lt;0.05). The risk of anal infection in patients with cervical cancer and precancer was 64% and </span><span lang="EN-GB">61.9</span><span lang="EN-US">% respectively (both p&lt;0.05). The most common HPV types detected in the anus were 16 (</span><span lang="EN-GB">53.6</span><span lang="EN-US">% of all anal HPV-positives), followed by 31 (</span><span lang="EN-GB">17.9</span><span lang="EN-US">%) and 51 (14.3%). In </span><span lang="EN-GB">84.5</span><span lang="EN-US">% of cases, the same HPV type was present in the anus and gynaecological organ.</span></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><strong><span lang="EN-US">Conclusion</span></strong></p><p class="MsoNormal" style="margin:0cm 0cm 6pt;text-align:justify;line-height:26.6667px;font-family:&#39;times new roman&#39; , serif;color:rgb( 0 , 0 , 0 );letter-spacing:normal;font-size:10pt"><span lang="EN-US">Patients with HPV-RGD, HIV-negative, are at risk for synchronous anal HPV infection, with type 16 being the most common. Further research is warranted to define the clinical significance of this finding and the introduction of anal cancer screening among patients with HPV-RGD.</span></p>