Could HPV Type 33 Be More Risky Than We Thought?

Area of Science:

• Gynecology
• Oncology
• Virology
• Public Health

Background:

• Human papillomavirus (HPV) is a primary risk factor for cervical cancer, with HPV 16 and 18 being the most prevalent genotypes.
• Other high-risk HPV (hrHPV) types also significantly contribute to invasive cervical disease, necessitating a comprehensive understanding of their prevalence.
• The management of hrHPVs beyond HPV 16/18 requires further investigation, particularly in patients with cervical intraepithelial neoplasia (CIN).

Purpose of the Study:

• To determine the association frequency of HPV 16, 18, and other hrHPV types with CIN 2+ cervical lesions.
• To contribute to the literature on managing hrHPV infections, focusing on types other than HPV 16 and 18.
• To evaluate the predictive value of specific hrHPV types for CIN 2+ lesions.

Main Methods:

• A retrospective study analyzed 202 patients (initially 264) with CIN between March 2020 and May 2022.
• HPV 16, 18, and other hrHPV types were assessed in patients aged 25-65 with negative cytology.
• Colposcopy-guided biopsies were performed, and patients with CIN 2+ lesions underwent excisional procedures; genotype distribution was examined.

Main Results:

• HPV 16 was detected in 43.3%, HPV 33 in 30%, and HPV 18 in 10% of patients with CIN 2+ lesions.
• HPV 33 positivity showed a significant positive correlation with CIN 2+ lesions (r=0.290, p<0.000) and increased the probability of such lesions by 4.999 times.
• HPV 45 positivity was negatively correlated with CIN 2+ lesions (r=-0.172, p<0.015), but both HPV 33 and HPV 45 were significant predictors of CIN 2+.

Conclusions:

• The role of hrHPVs other than HPV 16/18 in cervical preinvasive lesions with negative cytology remains incompletely understood.
• HPV 33 demonstrates a strong association with CIN 2+ lesions, suggesting immediate colposcopic biopsy is warranted for HPV 33 positive individuals.
• This finding supports prompt intervention over a one-year follow-up for patients positive for hrHPVs other than the most common types.