[1480] ASC-US: Is There a Correlation between High-Risk HPV and Vaginal Infections

EE Bogdan, M Koch, V Du, GM Oprea-Ilies. Emory University - Oxford College, Atlanta, GA; Midwestern University, Phoenix, AZ; Emory University, Atlanta, GA

Background: ASC-US by the new Bethesda guidelines represents a cytopathologic interpretation of uncertainty that is reflex tested for human papilloma virus (HPV) presence. FDA approved the use of HPV testing in conjunction with the liquid prep Pap Test for cervical cancer screening in March 2003. Our institution, which serves a high-risk population, uses a commercial probe to test for high-risk HPV (HR-HPV) in liquid prep Pap test.
Design: The files of our institution were searched for Pap tests diagnosed as ASC-US and HR-HPV test. These cases were studied in correlation with associated vaginal infections: Candida (C), Bacterial Vaginosis (BV), Trichomonas vaginalis (T), Herpes virus and the amount of inflammation. Additional data included age at the time of the test. The data were entered into an excel spreadsheet. Statistical calculation was performed using chi square test.
Results: A total of 4089 Pap tests were diagnosed with ASC-US and had HR-HPV test performed. 1040 (25%) were positive and 2327 (56%) negative. 722 (19%) have not been tested for HR-HPV. The age distribution was: 3243 (80%) < 50 year of age, 846 (20%) > 50 years of age. Of the HR-HPV positive cases, 125 (12%) showed C, 99 (9.5%) showed T, 247 (23.75%) showed BV, 4 (0.38%) showed Herpes, 332 (31.9%) mild, 481 (46.25%) moderate, 153 (14.7%) severe infections and 60 (5.8%) an association of those. Of the HR-HPV negative cases, 227 (9.75%) showed Candida, 170 (7.3%) showed Trichomonas, 329 (14.1%) showed bacterial vaginosis, 2 (0.08%) showed Herpes, 724 (31.1%) mild, 1108 (47.6%) moderate, 352 (15.1%) severe infections and 135 (5.8%) an association of those. See table.

	HR-HPV +N= 1040 (25%)	HR-HPV – N=2327 (56%)	P-VALUE
CANDIDA	125 (12%)	227 (9.75%)	0.0497
TRICHOMONAS	99 (9.5%)	170 (7.3 %)	0.0369
BACTERIAL V.	247 (23.75)	329 (14.1%)	0.0001

*The other characteristics did not show significant differences.


Conclusions: Conclusions: ASC-US associated with morphologically diagnostic infectious organism is most likely to correlate with HR-HPV infection. Two explanations may be considered: 1. Women who are infected with C, T, and the organisms responsible for BV have a higher risk for other sexually transmitted diseases such as HPV. 2. A second explanation may be that cytopathologists tend to downgrade nuclear changes in the presence of overt infectious organisms.
Category: Infections

Wednesday, March 24, 2010 1:00 PM

Poster Session VI # 220, Wednesday Afternoon