THE HPV-DETERMINANTS OF CIN-I

Correlates of HPV amongst a cohort of women with a CIN I detected by a screening Pap test were investigated. Co-incident CIN II/III lesions were identified and their influence on the HPV status and HPV determin ants of screening detected CIN I was assessed. Based on both the colpo scopic impression and repeat Pap test, 537 women referred for examinat ion of a Pap test classified as CIN I were triaged into two groups. Gr oup A lesions were assessed as </= CIN I; n = 342 (63.7%) and group B as >/ CIN II; n = 195 (36.3%). Clinical, demographic, reproductive, an d risk factor for cervical cancer correlates were collected. HPV typin g of cervical scrapes collected at the colposcopic examination was don e by PCR amplification using seven sets of type specific and one set o f consensus primers. HPV positivity was identified in 47% of all scrap es; types 16/18 (28%), 31/33/35 (10%), 6/11 (2%), and unknown (7%). Th e HPV status of the cohort and group A were very similar. Group B had a slightly higher rate of HPV positivity (52%) due to an increase in t ypes 16/18. Statistically significant correlates of HPV prevalence or type were not identified either for the entire group or both triage gr oups, however in each group, HPV positive women tended to be younger a nd to have more sexual partners. Co-incident CIN II/III spuriously inc reased the HPV prevalence rate of CIN I detected by a screening Pap te st. The HPV appears to be sexually transmitted both in low and high gr ade lesions and explains why the HPV determinants of the entire cohort were unaffected by the co-incident CIN II/III.