Fatores associados a infecção por HPV e lesão intraepitelial em canal anal de mulheres imunocompetentes com lesão intraepitelial genital

Abstract

Human papillomavirus (HPV) occurs in 90% of patients with anal cancer. Anal cytology seems to be useful in screening for anal intraepithelial lesions and anal carcinoma, especially in high-risk populations, and its use may indicate patients who should undergo anoscopy. In Brazilian women with HPV genital lesions, there are few studies about the prevalence of HPV infections in other sites and which methods can identify positive cases, leading to risk factors into account. This study aimed to research oncogenic high-risk HPV and abnormal anal cytology in immunocompetent women with HPV genital lesion. An analytical cross-sectional, observational study was conducted in immunocompetent women, with and without genital intraepithelial lesions, attended in a specialized outpatient clinic of a tertiary hospital in Fortaleza-CE, from July 2017 to December 2018. There were 57 women, divided into 2 groups: Group 1 – women with HPV genital lesion (n=26) and Group 2 – women without HPV genital lesion (n=31). Patients were submitted to cervical and anal samples for liquid-based cytology and high-risk DNA-HPV research by real-time PCR. All of them were submitted to anal evaluation by high-resolution anuscopy, and biopsies were performed when needed. Excel spreadsheet with variables data was organized, and the data were exported to the Jamovi 0.9.5.12 program. Fisher's exact and chi-square tests were applied for consolidated data in the contingency table, as well as the Student t-test and Mann-Whitney U testfor independent variables. Results: There was no statistical difference between the groups in relation to abnormal anal cytology or anuscopy, and there was no histopathological result of anal intraepithelial lesion in any of the groups. Anal oncogenic HPV infection was more frequent in group 1 (OR 4.95; 95% CI, 1.34-18.3; P= .012) and oncogenic HPV infection simultaneously in the cervix and anus was also more frequent in group 1 (OR 18.8; 95% CI, 2.20-160; P< .001). The presence of cervical oncogenic HPV was associated with anal oncogenic HPV (OR 4.95; 95% CI, 1.34-18.3; P= .012). Conclusion: Women with HPV genital lesion and cervical oncogenic HPV have a higher frequency of anal oncogenic HPV.