Comparison of Cytological and/or Histopathological Results of Patients with Single and Multiple HPV Positivity.

Abstract

Introduction: This study aimed to evaluate the impact of single and multiple human papillomavirus (HPV) positivity on cervical intraepithelial lesions, specifically focusing on whether the addition of high-risk HPV types to HPV-16 or HPV-18 affects the progression to high-grade lesions.

Methods: A retrospective analysis was conducted on 612 HPV-positive patients from Karadeniz Technical University Faculty of Medicine, Department of Obstetrics and Gynecology (2018-2023), who underwent Pap smear and HPV genotyping. Demographic, cytological, and histopathological data were collected, with HPV types categorized as HPV-16, HPV-18, and other high-risk types. Colposcopic biopsy results were used to assess the risk of cervical intraepithelial neoplasia.

Results: Among 612 HPV-positive patients, 137 had HPV-16 (17.4%), 39 had HPV-18 (4.9%), and 503 had other high-risk types (63.8%). HPV-16 and multiple high-risk HPV types exhibited a higher proportion of cytological abnormalities. Histopathological analysis showed that the presence of other high-risk HPV types alongside HPV-16 was associated with a lower risk of progression to high-grade lesions compared to HPV-16 alone. Specifically, HPV-16 combined with other high-risk types showed a significantly lower rate of cervical intraepithelial neoplasia.

Conclusion: The addition of other high-risk HPV types to HPV-16 may slow the progression to high-grade cervical lesions, contradicting the literature that suggests multiple HPV infections increase the risk. These findings contribute to the ongoing debate on the role of multiple HPV types in cervical lesion progression.

Key message: The presence of additional high-risk HPV types alongside HPV-16 may reduce the likelihood of progression to high-grade cervical lesions, suggesting a possible attenuating effect of multiple HPV infections rather than a synergistic risk.