Investigation of the relationship of HİGH risk human papilloma virus genotype and developing pathology

The aim of this study is to demonstrate the clinical importance of colposcopic examination of the cervix, histopathological evaluation in patients infected with HR-HPV genotypes, and to contribute to the management of patient groups with a high probability of pre-invasive and invasive neoplasia. The study was designed as a retrospective cohort, and 905 women who applied to the Obstetrics and Gynecology outpatient clinics of Başkent University Medical Faculty Hospital between 28.04.2011 and 31.12.2018 were included. The HR-HPV DNA test were positive in all subjects. All HPV DNA test were performed at the laboratories of our ficilities. Data of the subjects were retrospectively scanned, recorded and compared. The order of most prevalent single and multipl HPV serotypes in infected subject were as follows; 9.3% HPV16, 7.5% HPV31, 5.5% HPV18, 5.2% HPV52, 4.5% HPV39, 4.5% HPV68, 4.5% HPV16+18, 4.2% HPV35, 3.7% HPV56, 3.5% HPV66 and 3% HPV35+39+51+56+59+66+68. Patients with HPV16,18,33,39,56 were significantly more common in subjects before the age of 40 (n=160, 32.5%, n=105, 21.3%; n=31, 6.3%, n=78, 15.9; n=82, 16.7% respectively.) (p=0.001; p=0.02; p=0.04; p=0.04; p=0.009 respectively). Although, the rate of other HR-HPV types were also higher in the group before the age of 40, there was no significant difference. When investigating the factors affecting the biopsy results, we found that smoking had a significant effect on abnormal biopsy results [OR = 0.52; (p=0.021; 95% CI; 0.307-0.908)]. We also found that smear results were significantly affected in terms of HPV18, 31, 39, 68 were infecting the patient alone or in coexistance with multipl HPV agents (p=0.001; p=0.003; p=0.01; p=0.002 respectively). The data obtained from our study emphasize the importance of HPV DNA test in the existing screening program together with the smear test. While studies around the world continue for identifying the ideal screening test, current data suggest the combined use of HPV DNA testing and servical smear. Even recent data (ACS 2020 recommendations) recommend the use of HPV DNA testing alone. Although, evaluating the HPV test alone increases the rates of colposcopy, it provides a higher rate of pre-invasive lesion detection and even indicates invasive lesions that cannot be predicted by the smear test.