Epidemiological characteristics of women with high grade CIN who do and donot have human papillomavirus

Objective Human papillomavirus infection is an important aetiological agent associated with the development 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 cas es of dysplasia. This study aimed to determine if there are epidemiological differences between women who are positive or negative for human papilloma virus, with high grade cervical intraepithelial neoplasia (CIN). Design Four hundred and sixty women with CIN II and III lesions were studie d. To ensure optimal detection of human papillomavirus DNA two specimens !i .e. tampon and cervical biopsy) were collected from each woman and tested b y three techniques: L1-polymerase chain reaction, EG-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 an d E from each patient. Human leucocyte antigen (HLA)-DQB1 alleles were also compared between the groups of women who were positive or negative for hum an papillomavirus. Results Overall, human papillomavirus DNA analysis was positive in 411 wome n (89%). Age, number of sexual partners in the last 12 months, past pregnan cy and marital status were associated with human papillomavirus detection i n the crude analysis. However, in the adjusted analysis no epidemiological features remained significantly different between the human papillomavirus positive and negative patients. Moreover, examination of vitamin A, E and b eta-carotene levels did not show a significant difference between the two g roups of patients. However in the HLA-DQB 1 allele profile a significantly higher proportion of women who were negative for human papillomavirus had D QB1 *0201,*0603 and *0604 (P = 0.05, 0.001, 0.03, respectively). Conclusion We did not find a significant difference in epidemiological fact ors between women with human papillomavirus positive and negative high grad e CIN. However differences between the frequency of three HLA DQB1 alleles suggest that women with these allele profiles have a higher chance of clear ing human papillomavirus, without affecting their chance of developing dysp lasia.