A PCR STUDY ON THE COEXISTENCE OF HERPES-SIMPLEX VIRUS, CYTOMEGALOVIRUS AND HUMAN PAPILLOMAVIRUS DNAS IN CERVICAL NEOPLASIA

There is strong epidemiological and biological evidence that the devel opment of squamous cell carcinoma of the cervix is a multistep process in which human papillomaviruses (HPVs) play a crucial but not total r ole and where the synergistic effect of herpes simplex virus (HSV) and human cytomegalovirus (HCMV) has been suggested. The presence of HPV, HSV and HCMV deoxyribonucleic acids (DNAs) was assessed by a polymera se chain reaction (PCR) in cervical biopsies obtained from 41 women wi th cervical neoplasia (21 high-grade cervical intra-epithelial neoplas ia (GIN) and 20 squamous cell cancers) and 33 controls. Human papillom avirus 16 DNA was significantly more common in high-grade CIN (57%) an d cancer (50%) than in normal cervix (9%). Herpes simplex virus and HC MV DNAs were present in 12% and 21% of normal cervices, 19% and 24% of high-grade GIN, and 25% and 25% of cancers, respectively. After adjus tment for patients' age, coinfection associating high-risk HPVs (HPV 1 6 and/or HPV 18) and herpes viruses (HCMV and/or HSV) were observed in cervical neoplasia (odds ratio (OR) = 19.11; 95% confidence interval (CI): 2.14-170.36). Conversely, the OR for infection by HPV 16 and/or HPV 18 alone did not reach statistical significance (OR = 7.22; 95%CI: 0.85-61.16). Moreover infection by HCMV and/or HSV alone (OR = 0.89; 95%CI: 0.33-2.24) was not associated with cervical neoplasia. Our resu lts support the role of HSV and HCMV as cofactors of HPV 16 and HPV 18 in cervical neoplasia.