Dynamic of HPV-associated cervical infection during pregnancy

Infections with the human papillomavirus (HPV) are thought to be strong ris k-factors for the development of cervical dysplasia and carcinoma. The aim of this study was to observe possible changes in the infection status durin g the course of pregnancy. During the 12th gestational week cervical smears were taken from 225 pregnant women and were analysed for the presence of H PV-infections using a hybridization antibody capture microplate assay (DIGE NE II(R)). If the test was positive it was repeated during the 34th gestati onal week and after delivery. Statistical analysis was carried out using st andard descriptive parameters, sign tests for changes over time and Kendall tests for the evaluation of possible correlations between HPV-status and a ge and parity. During the first examination 66 tests (29 %) were positive. Of these, 14 (21 %) indicated an infection with only "low-risk" and 52 (79 %) with "high-risk" variants of the virus. During the 34th week the pattern shifted to the following: 26 (41 %) were negative, 2 (3 %) had only "low-r isk" and 35 patients (56 %) had "high-risk" infections. At the final examin ation after delivery 30 (57 %) were negative, 4 (8 %) were positive with on ly "low-risk" and 18 (35 %) with "high-risk"types of HPV. Of the 14 women w ith a "low-risk"infection during the 12th week of gestation only 3 were pos itive during the 34th week. Of the 52 "high-risk" patients 34 were still po sitive at the second examination and 26 were still positive after delivery. Changes were seen to be statistically significant in women with "low-risk" as well as "high-risk" infections (p = 0.0117 and 0.0074). Neither age- no r parity-related correlations could be found. In conclusion, the incidence of pre-existing HPV-infections decreases during the course of pregnancy. Th is change seems to be more obvious in infections with "low-risk" than in th ose with "high-risk" variants of HPV.