Detection of anal HPV presence in cases with cervical HPV persistence

HPV infection is common today. Persistence of HPV infection causes the development of many cancers, especially cervical cancer. It usually causes squamous cell cancers and can cause cancer in different parts of the body. One of these areas is the anal canal. There is an increase in the number of intraepithelial lesions of the anal canal and anal canal squamous cell cancers. HPV plays an active role in the development of both pathologies. While an HPV-based screening program is active in cervical cancer, such screening is not performed in anal canal cancers. It is thought that this health problem will increase in the coming years and measures should be taken for this. One of the main goals is to prioritize the risky population group that can be identified. For this purpose, in this study, we aimed to determine the risk group in terms of the presence of anal HPV. Within the scope of the study, patients who applied to Pamukkale University Faculty of Medicine Gynecology and Obstetrics Clinic with cervical HPV infection were evaluated. Colposcopies were performed in these patients in the past due to cervical HPV infection, and biopsies were taken when necessary. Follow-up continued in our clinic. Within the scope of the study, 286 patients with positive cervical HPV infection were examined in our clinic, and the historical histopathology results and cervical HPV infection history of these patients were evaluated. Patients were grouped according to their persistence of cervical HPV infection. Within the scope of the study, current cervical HPV results, anal HPV results and demographic data of the patients were examined. Additionally, patients were evaluated in terms of risk factors that could be considered criteria. Cervical HPV samples were also taken along with anal HPV samples of the patients participating in the study. All patients had a history of HPV. When looking at the cervical HPV history of 286 patients before the study, HPV type 16 was positive in 142 samples (49.7%); HPV type 18 was positive in 36 samples (12.6%), and other hr-HPV types were positive in 176 samples (61.5%). When the final cervical HPVs of these patients were evaluated, HPV type 16 was detected in 27 samples (9.4%), HPV type 18 was detected in 4 samples (1.4%), and other hr-HPV was detected in 58 samples (20.3%). Since there are samples in which more than one HPV type is detected, the percentages are not 100%. It is thought that this decrease in cervical HPV infection is due to regular follow-up and treatment of patients and the normal regression course of HPV infection. When anal HPV samples of 286 patients were evaluated, readings could not be made in 9 samples (3.1%) due to insufficient sample size. The presence of anal HPV was detected in 70 of the remaining 277 patients (24.5%), and the presence of anal HPV was not detected in 207 patients (75.5%). When we look at anal HPV types, HPV 16 in 21 samples (30%); The presence of HPV 18 was detected in 6 samples (18.6%) and other hr-HPV was detected in 51 samples (72.9%). No statistically significant difference was found between the patients' menopausal status, active or passive smoking, whether they were diagnosed with diabetes mellitus (DM), whether they had a history of oral contraceptive use, and the presence of cervical intraepithelial lesion (CIN) and the presence of anal HPV. The presence of anal HPV was statistically significantly higher in patients with a history of intrauterine device (IUD) use (p=0.036). When evaluated in terms of cervical HPV persistence, it was concluded that the presence of anal HPV was more common in patients with cervical HPV persistence (p<0,001). Logistic regression analysis was performed for IUD use history and cervical HPV persistence, and IUD use history was no longer an independent risk factor. Cervical HPV persistence remained significant and the odds ratio was 2.9 and the 95% confidence interval was 1.6-5.1. Anal HPV infection numbers are higher than expected. No specific population at risk from the presence of infection has been identified. When the HPV types detected positive and the patients' stories were examined, it was seen that the HPV types in the cervical and anal canals differed significantly. This shows that regardless of the person's cervical HPV result, there is a risk of high-risk HPV type in the anal canal. As a result of our study, although patients with a history of IUD use and cervical HPV persistence appear to be at higher risk, large-scale studies are needed to determine the mechanisms and confirm the accuracy of our results.