Anal HPV prevalence exceeds genital detection in female transplant recipients

Objective Transplant recipients receiving immunosuppressive therapy have a higher risk of developing anogenital HPV-related (pre)malignancies. We investigated the prevalence of anal and cervical high-risk (hr) HPV infection in female transplant recipients.

Methods Women (n=201) after kidney (n=108) or liver (n=103) transplantation with at least one year after transplantation were HPV tested and genotyped (cobas 6800; Roche diagnostics and Anyplex™ II HPV28; Seegene) at anal and cervical sites on swabs (anal: Bruker eSwab™ system; cervical: Rovers Cervex-Brush). A questionnaire captured sexual behaviour, medical treatment history and demographic data.

Results A cervical hrHPV infection was detected in 32 (15.9%) of the 201 included patients. The most prevalent genotype was HPV16 (31%). No significant difference in HPV prevalence between liver (15.05%) and kidney (17.3%) was found. Increased hrHPV prevalence was not attributable to transplant specific risk factors like type and duration of immunosuppressive therapy. Anal hrHPV showed an overall prevalence of 20.3% (40/197), HPV16 was detected in 17.5% (7/40). The co-prevalence of hrHPV detected in anal and cervical sites was 68.8%. 28/32 patients with cervical hrHPV infection attended clinical follow-up and intraepithelial neoplasia was detected in 3 women (1xCIN2, 1xCIN3, 1x VaIN3). The HPV vaccination rate was 12.4% (25/201) and 68% (17/25) of patients received their vaccination before first sexual intercourse.

Summary Data indicates that cervical HPV prevalence is high in transplanted women. In comparison the overall anal hrHPV detection rate is even higher, suggesting that regular anal screening should be discussed in immunocompromised transplant recipients.

Publikationsverlauf

Artikel online veröffentlicht:
11. Oktober 2022