HPV subtype analysis in lower genital tract neoplasms of female renal transplant recipients

Objective. Immunocompromised patients, such as female renal transplant reci pients, have an increased incidence of neoplasms involving the lower genita l tract (i.e., cervix, vagina, vulva). The relationship between lower genit al tract neoplasms and human papillomavirus (HPV) infection has been establ ished and high-risk oncogenic subtypes have been identified (HPV 16, 18, 45 , and 56). The purpose of this study is to evaluate HPV subtypes present in lower genital tract neoplasms of post renal transplant women and compare H PV subtypes found in these patients with immunocompetent patients having si milar neoplasms and normal immunocompetent controls. Methods. Twenty specimens from lower genital tract neoplasms of 16 renal tr ansplant patients, 13 specimens from 13 immunocompetent patients with simil ar histology, and 13 patients with normal lower genital tract histology wer e analyzed for the presence of HPV using polymerase chain reaction. HPV pri mers including the L1 Gate) region consensus primers and primers specific f or the HPV E6 (early) region for subtypes 6, 11, 16, and 18 were amplified with DNA from the above patient samples. Results. Overall, HPV was detected in 21/46 specimens tested. Thirteen of t he HPV-positive specimens were from transplant patients, and 8 were from im munocompetent patients (5 immunocompetent with disease and 3 normal patient s). This difference in the total number of HPV-positive cases was statistic ally significant between the transplant and immunocompetent group (P = 0.02 ). Although no difference in HPV 6 and/or 11 was detected between the two g roups, HPV subtypes 16 and/or 18 approached statistical significant differe nce (P = 0.06). Conclusions. High-risk oncogenic HPV subtypes 16 and/or 18 were found at a higher rate in transplant patients compared with their immunocompetent coun terparts. The combination of immunocompromise and increased HPV 16 and/or 1 8 positivity may place these patients at increased risk for aggressive lowe r genital tract neoplastic progression. (C) 2000 Academic Press.