A Pilot Study of Anal Cytology and Anal Human Papilloma Virus (HPV) Infection in Women with High-risk Cervical HPV Infection
Nuttavut Kantathavorn MD1,2, Usanee Chatchotikawong MD2, Narongrit Sritana MSc3, Thaniya Sricharunrat MD4, Wasanai Krisorakun MD2, Asama Vanichtantikul MD2, Narongchai Teerayathanakul MD4, Siriporn Saeloo BNS5, Waraphorn Krongthong MSc5, Wandee Udomchaiprasertkul MSc3
Affiliation : 1 Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand 2 Gynecologic Oncology Division, Woman Health Centre, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Thailand 3 Molecular Biology and Genomic Research Laboratory, Division of Research and International Relations, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Thailand 4 Department of Pathology, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Thailand 5 Data Management Unit, Division of Research and International Relations, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Thailand
Background : Anus is in a pelvic region close to cervix and may be a reservoir for human papilloma virus [HPV] infection.
Hence, anal HPV infection may have similar result of cervical origin and could probably be used for cervical cancer screening.
Objective : To evaluate the concordance of anal HPV and cervical HPV infection and anal cytology in women with high-risk
cervical HPV infection.
Materials and Methods : Between July 2011 and May 2012, we enrolled 38 Thai women, 20 to 70 years of age, with high-
risk cervical HPV infection who consented to the study. We evaluated the concordance of anal HPV typing using a LINEAR
ARRAY® HPV Genotyping test that can detect 12 types of high-risk HPV and 25 types of non-high-risk HPV and anal
cytology using BD Sure Path Pap test kit.
Results : The mean age was 39.5 years, (range, 22 to 61 years) and the mean age of sexual activity onset was 22.8 years. Seven
participants (18.4%) were menopausal, and 30/38 (78.9%) participants were sexually active. Overall HPV DNA was
detected in 19/38 (0.04%) anal samplings, and 12/38 participants (31.6%) had at least one high-risk HPV genotype. Type
specific (at least one type) match of high-risk HPV accounted for 11/38 (28.9%). The HPV genotypes distinguished in anal
samples were predominantly HPV 16 (6 cases); HPV 6, 58, 61, and 84 (2 cases each); and HPV 18, 33, 39, 40, 45, 51, 53, 56,
60, 68, 72, 73, 81, and IS39 (1 each). Cervical HPV was detected without concurrent anal HPV detection. All anal cytology
results were negative.
Conclusion : Low rates of cervical and anal high-risk HPV concordance in this study (approximately 30%) suggest that anal
HPV test cannot be used as a substitute for cervical HPV test in cervical cancer screening program.
Keywords : Anal cytology; Human papilloma virus [HPV]; Linear array; Concordance rate; Cervical cancer
