HPV Infectivity of Products of Conception: An Age-Specific Prevalence Study
Theresa Duong, Christine Adamson, Vanitha Rajendran, Brenda Waters, Mark Evans. Fletcher Allen Health Care, Burlington, VT
Background: Several studies have suggested an association of HPV infection with aborted products of conception (POC). However, previous studies of HPV POC infections have examined limited numbers of specimens and have not addressed the epidemiology of HPV infection in U.S. women. The highest burden of HPV infection is found in females 20-24 years of age; females 25-29 years of age may have almost half the HPV prevalence. The aim of this study was to use a larger scale case-control study design to investigate HPV as a causative factor in aborted POC and to assess HPV infection in relation to patient age group.
Design: The study included 201 specimens: 100 specimens of archival formalin-fixed, paraffin-embedded (FFPE) POC: 20-24 years (n=50) and 25-29 years (n=50), and, 101 controls of term FFPE placenta samples; 20-24 years (n=51) and 25-29 years (n=50). HPV genotyping of purified DNA extracts was performed by GP5+/GP6+ PCR and cycle sequencing. Chromogenic in situ hybridization (CISH) was performed for HPV on the PCR positive cases.
Results: HPV was detected in 20/201 (10%) specimens by PCR: 1 low risk type (HPV-11 [n=1]) and 5 high risk types (HPV-16 [n=11], 18 [n=2], 51 [n=1], 59 [n=1], 66 [n=4]). There were no statistically significant differences of HPV prevalence between the two age groups comparing POC specimens, term placenta controls, or POC and controls combined; 20-24 age group: HPV was detected in 16.0% POC samples and in 7.8% term placentas (p=0.23); 25-29 age group: HPV was detected in 10% POC and in 6.0% term placentas (p=0.48). Overall, HPV was detected in 11.9% of the 20-24 group and in 8.0% of the 25-29 group samples (p=0.48). CISH was negative for HPV in all specimens tested.
Conclusions: These data are unsupportive of HPV contributing to the etiology of spontaneous miscarriage. By PCR, HPV was (statistically) as common in control placentas as in POC. The prevalence of HPV in aborted POC was not directly reflective of the prevalence of HPV infections in younger age group females in the U.S. The CISH data are suggestive that the HPV detection by PCR represents a low copy number of incidental or latent infection. Further studies are required to elucidate the factors that contribute to a placental sample testing HPV positive and the significance, if any, for patient or fetal health.
Category: Gynecologic & Obstetrics
Wednesday, March 21, 2012 1:00 PM
Poster Session VI # 212, Wednesday Afternoon