LONGITUDINAL-STUDY OF THE EFFECTS OF PREGNANCY AND OTHER FACTORS ON DETECTION OF HPV

Objective: An epidemiologic study of 108 pregnant and 192 nonpregnant women was carried out to determine the effects of pregnancy and other factors on the detection of HPV infection, since both or larger number s of pregnancies and HPV infection are known to be risk factors for ce rvical cancer. Patients and methods: Study participants were followed up at 3-months intervals for a period of 1.5 months (1-6 months after delivery). At each visit, two cervical specimens were taken, one for r outine cytology and a second for HPV DNA hybridization using Virapap/V iratype, and a 5-ml blood sample was taken and a self-administered que stionnaire was completed. Results: In cervical specimens of the initia l examination, HPV DNA was detected among 5.0% of pregnant and 5.2% of nonpregnant women, whereas HPV 16/18 was found in 80% of the HPV-posi tive specimens. Using multiple cervical specimens taken over time, 13. 9% of the pregnant and 15.1% of the nonpregnant women tested positive for HPV DNA at least once. Adjusted for study group, age, and the numb er of available cervical specimens, ever detection of HPV infection (a ny type) was associated with more sexual partners and larger numbers o f cigarettes smoked daily. An autoregressive generalized linear model was used to analyze the time-dependent multiple observations per study subject. Adjusting for age and trimester of pregnancy, the determinan ts of detecting high-risk HPV types (16/18 and 31/33/35) in the cervic al specimen were an abnormal Pap smear, a positive HPV result in a pre ceding specimen, more than six sexual partners in the lifetime, and cu rrently smoking more than 20 cigarettes per day with odds ratios of 10 .9, 5.6, 3.2, and 2.7, respectively. Conclusion: Our data provide no e vidence for a higher detection rate of HPV during pregnancy. (C) 1996 Academic Press, Inc.