PAPILOMAVÍRUS HUMANO (HPV) EM ADOLESCENTES DE UMA ESCOLA PÚBLICA EM SÃO LUÍS MA

Abstract

The human papillomavirus (HPV) is the agent of most common sexually transmitted infection in adolescence worldwide. The cervical cancer, related to this infection, is the leading cause of death in Maranhão. The biomolecular diagnosis used to HPV detection is the polymerase chain reaction (PCR). It is proposed to investigate the frequency of the HPV genotypes in high school students from a public school in Sao Luis by different diagnostic methods. We conducted a cross-sectional study, descriptive at adolescents in high school, totaling 39 female students aged 15 to 19 years in the period July 2008 to June 2009. A questionnaire covering socio-demographic and sexual behavior was used. It was carried out cytopathology, colposcopy, cervical biopsy and genotyping by Nested PCR in each sample. The inclusion criteria were presence of sexual activity and we excluded women who had no sexual activity, those with positivity for HIV and pregnant. The data were transferred to a spreadsheet in the software Excel 2007 and evaluated using Epi-Info 6.04. The socio-demographic data showed that most female adolescents studied was 15 to 17 years old, they lived in urban area and they were full-time students, they were white and had schooling from 12 to 14 years. In 25 (64.1%) adolescents, the first sexual intercourse occurred before age 16 (p = 0.240), half said to have among one and four sexual intercourses per week (p = 0.082), one partner (51.3%), and two to three partners (38.5%), 82% reported ever having had STDs (p = 0.704). Three reported abortion (p = 0.463). One reported having given birth to 17 years. As for gynecologic complaints, the main were leukorrhea (79.5%, p = 0.016) and pruritus (23.1%, p = 0.928). Eight (20.5%) reported family history of cancer. At colposcopy, there were no vulvar or vaginal lesions and we diagnosed minor injury in seven adolescents (17.0%). The Pap smear result showed inflammation in 37 (94.9%) and LSIL / HPV in a test. Histopathology was performed in 15 students (38.5%), and seven had changes suggestive of HPV. Genotyping was positive in 29 students (74.3%), predominantly to 14 high-risk genotypes in 21 (72.4%) adolescents, namely: 16, 18, 31, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 82, distributed in multiple coexisting and simple infections. In assessing the accuracy of Nested PCR, positive predictive value was 85.7% (true positives), and negative predictive value was 12.5% (true negatives), Nested PCR provides useful diagnostic information to the study of human papillomavirus, as multiple and simple infections diagnosis.