VALUTAZIONE DELLA COMPRESENZA DEL PAPILLOMAVIRUS (HPV) IN SEDE ORALE E GENITALE IN DONNE CON CITOLOGIA CERVICALE POSITIVA E NEI RISPETTIVI PARTNER

Introduction/Objective The human papilloma viruses (HPVs) are DNA viruses associated with benign and malignant lesions. For gynaecologists, the carcinogenic potential and the necessity of HPV presence for the development of cancer has been understood for decades in relation to the cervix uteri, and for a large portion of other anogenital tumours. The HPVs have been studied in last decades also by many other different specialist due to its role in association with numerous different cancers in several tissues including Head and neck squamous cell cancer (HNSCC) and Oral Squamous Cell Carcinoma (OSCC). HNSCC accounts for more than 7 % of all human cancer types. Despite the development of new surgical techniques and the introduction of multidisciplinary treatments still almost half of the patients decease. For a long time period smoking and alcohol were the main risk factors contributing to HNSCC. Even if a decline in smoking has been registered from '70s till now, the incidence of OSCC is still rising. This might be explained by an increasing of HPV positive tumors. For this reason the women’s HPV-positive cervix is discussed to act as a virus reservoir. However, until today it remains unclear if the women’s HPV-positive cervix uteri really serves as a virus reservoir and if certain sexual practices are the cause for HPV transmission to the oropharynx. Data on genotype-specific concordance of oral-oral and genital-oral HPV infections among heterosexual couples are key to understand HPV transmission between partners. This study aimed at assessing the concurrence of oropharyngeal HPV infection, with relative genotyping, in women with cervical lesions and in their current stable sexual partners in an Italian population. Material and methods 105 female subjects with a positive PAP test were enrolled in this study. Complete datas, cervical brush, oral swab, oral rinse and urine (only male) samples were collected from 44 women and 28 men. Demographic and behavior data were obtained through a structured questionnaire. HPV-DNA amplification was performed by polymerase chain reaction assay (PCR) using both primers MY09/MY11 and FAP59/64. HPV genotyping has been performed with Sanger technique and each sequence compared with the Finch software and "The PapillomaVirus Episteme" (PaVE) database. Positive samples have been analyzed also with the Inno-Lipa Genotyping Extra kit in order to have an higher accuracy in case of multiple genotype infections. Different variables were considered for the statistical analyses: gender, age, number of partners, oral sex, alcohol consumption per week, lesions etc. The effect of the variables on the HPV infection status was assessed, by fitting a generalized model, using the GLM (General Linear Model) function in R software. The family “binomial” was used for the description of the error distribution and link function. The function fisher test was used to perform Fisher’s exact test as a verification test. The model was tested using the maximum likelihood to evaluate the effect of the inclusion of each parameter to the model. As a supplementary analysis, the correlations were calculated between all parameters. Results 86% of cervical samples were HPV-positive. Different genotypes have been isolated (i.g. 6, 66, 39, 16, 31, 56, 42, 58, 114, 59, 61, 68, 45, 35, 33 e 53, 89, 114). 20% of the oral samples were positive in the female group and 25% in the male one. Only one sample of urine was positive and the same HPV genotype has been found in the cervical brush of his female partner. No other specific genotype concordance has been found between female and male couples. The regression of the variables against the total infection status highlighted three si