Adeno-associated virus seropositivity and HPV-induced cervical cancer in Spain and Colombia

Extensive experimental and limited epidemiologic data suggest that adeno-as sociated viruses (AAV) can have antioncogenic activity and may be protectiv e factors for the development of cervical cancer. To examine the associatio n between AAV-2 IgG antibodies and cervical neoplasia in Spain and Colombia , we tested for AAV-2 antibodies using an ELISA assay for 109 women with in vasive cervical cancer, 100 population-based controls age-matched to the in vasive cases, 77 women with carcinoma in situ (CIN III) and 100 clinic-base d controls age-matched to the CIN III cases. Human papillomavirus (HPV) DNA was detected in cervical exfoliated cells by polymerase chain reaction usi ng HPV-LI and GP5+/6+ consensus primers. The prevalence of AAV-2 antibody t iters > 100 was significantly lower in invasive cervical cancer cases than control participants. When comparing women with invasive cancer with contro ls or with CIN III cases, a pattern of decreasing cervical cancer risk with increasing AAV-2 titers was observed. Elevated AAV antibody titers (> 100) were inversely associated with invasive cervical cancer (OR 0.3; 95% CI 0. 1-0.7), although results were not statistically significant after controlli ng for HPV (OR 0.4; 95% Cl 0.1-1.6). In contrast, AAV-2 antibodies were not significantly associated with the risk of CIN III (OR 1.4; 95% Cl 0.3-6.8) . These results provide supportive evidence that AAV infection may be a pro tective factor for the development of invasive cervical cancer. Alternative ly, the lower AAV-2 seroprevalence in invasive cervical cancer cases may be due to an immunosuppressive effect of cervical cancer on AAV antibody resp onse. To investigate whether a direct viral interaction is occurring, futur e studies should aim to resolve at what frequency AAV is found in the genit al tract and to clarify further whether AAV may infect the same HPV-positiv e cells in the cervix. (C) 2001 Wiley-Liss, Inc.