Retrospective analysis of alpha‐human papillomavirus (HPV) types in tissue samples from anogenital dysplasias – introduction of the RICH (Risk of HPV‐related Carcinoma in HIV+/− patients) score. (17th October 2019)

• Record Type: Journal Article
• Authors: Hildebrand, J.A.; Fischbeck, A.J.; Hundsdoerfer, B.; Clanner‐Engelshofen, B.M.; Marsela, E.; Wollenberg, A.; Flaig, M.; French, L.E.; Reinholz, M.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 34:Number 2(2020)
• Page Start: 377
• Page End: 384
• Publication Date: 2019-10-17
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.15932
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Chronic viral infections caused by highly contagious human papillomaviruses (HPVs) from the alpha genus are a substantial risk factor for tumour diseases. Objectives: The goal of this study was to compare the HPV infection pattern with histology in a patient group of immunocompromised HIV + and non‐immunocompromised patients with anal intraepithelial neoplasia. Materials and Methods: Tissue samples ( n = 210) from the anogenital area of 121 patients underwent retrospective histological and molecular examination for HPV DNA prevalence by chip analysis. The study was part of a cancer screening from the Dermatology Department of the LMU Munich, Germany. All data were collected and processed anonymously. Results: HPV 6 or 11 are more abundant in tissue samples from histologically diagnosed condylomata acuminata (47.7%) compared to grade 1, 2, and 3 intraepithelial neoplasias (IN 1‐3). Detection of high‐risk (hr) alpha‐HPV DNA was significantly higher in tissue samples from IN 3 (67.5%) compared to IN 1 and 2 (12.9%), and compared to condylomata acuminata (29.5%). No HPV types were detected in histologically unremarkable tissue samples. There was a significant association between the prevalence of HPV 16 and the classifications IN 1 to IN 3 ( χ 2 (2) = 13.62, P = 0.001). We identified a significant correlation between the prevalence of high‐risk and low‐risk (lr) HPV types and HIV, especially mixed infections of different HPV types correlated with high‐grade IN. Based on the present data, we suggest the risk of carcinoma in HIV +/− patients (RICH) score and test it in the 121 patients. Conclusions: hr alpha‐HPVs, mainly HPV 16, are associated with increased oncogenic potential of premalignant lesions (IN 1‐3), especially in HIV + patients. Based on the combination of HIV/HPV‐testing and histological analysis, we identified correlations that could potentially forecast the risk of malignant transformation and summarized them in the form of RICH score.