THE FREQUENCY OF HUMAN PAPILLOMAVIRUS DETECTION IN POSTMENOPAUSAL WOMEN ON HORMONE REPLACEMENT THERAPY

Postmenopausal women enrolled in the Iowa portion of the postmenopausa l estrogen/progestin interventions randomized clinical trial (n = 105) during 1989-1991 were studied for (i) the prevalence of human papillo mavirus (HPV) in this older age population (ages 45-64), and (ii) the association between hormone replacement therapies (HRTs) and changes i n detection of HPV over a 2-year time period. HPV is causative in most cervical and some other genital cancers and in the presence of steroi d hormones has been shown to increase neoplastic transformation by HPV in vitro. Using PCR to detect HPV DNA, the overall frequency of the v irus regardless of time period was 50.3% (n = 53) with a baseline (BL) frequency of 38.1% and the second year follow-up (FU) of 22.9%. The o ncogenic types HPV-16 (75.5%) and HPV-31 (20.8%) were the most commonl y reported. All those with persistently detected infection (10.5%), de fined as HPV+ at both BL and FU, were identified with HPV-16 or -18. B etween these two time periods there were no significant differences in HPV frequency between the placebo and combined HRT groups (BL-/FU+, 2 1% vs 18%; BL+/FU-, 71% vs 80%). While the study is based on a small s ample, the findings suggest that short-term use of HRTs is not associa ted with an increased risk of HPV detection, but assessment of effects from long-term use is needed. The data also indicate that the frequen cy of HPV found in older women is higher than previously suspected but that short-term changes in HPV detected in this age group are unrelat ed to the development of precancerous cervical lesions. (C) 1997 Acade mic Press.