Human papilloma virus infections and other risk factors as determinants of cervical intraepithelial neoplasia in Trinidad and Tobago - abstract

ABSTRACT

Human Papilloma Viruses (HPV) are considered to play a key role in the induction of malignant neoplasms of the cervix uteri but there have been no published reports on the prevalence of genital HPV infections among women in this region where the incidence of cervical cancer is high. The objectives of this study were to assess the overall and type-specific prevalence of HPV infections of the uterine cervix in a sample of urban and rural women with and without cytologically or histologically defined cervical intraepithelial neoplasia (CIN) in this population of non-hysterectomized, non-pregnant females aged 18 - 60 years. One hundred and sixty-nine urban women, roughly half of whom had abnormal cytological diagnoses and 159 rural women were examined colposcopically and directed cervical biopsies performed. Cases and controls were identified on the basis of results of examinations of these specimens. Z-tests, kappa statistic, chi-square, odds ratio and confidence limits and multivariate logistic techniques were used where appropriate. Overall prevalence of HPV infection was 6.7 per cent, HPV DNA was detected in 5.6 per cent of controls and only 6.3 per cent of cases. HPV type 16 was the commonest isolate (54.5 per cent). HPV positivity was not an independent predictor of the risk of CIN. Early coital onset, high parity, multiple sexual partners and high gravidity were the most significant, independent predictors of the risk of CIN (AU)