Genital and cutaneous human papillomavirus (HPV) types in relation to conjunctival squamous cell neoplasia: a case-control study in Uganda.

Maurits Nc de Koning,Catherine Harwood,Sebastian Lucas,Karin Purdie,Wim Gv Quint,Keith Waddell,Robert Newton,Charlotte Proby,Joseph Magyezi,Robert Downing

doi:10.1186/1750-9378-3-12

Abstract

BackgroundWe investigated the role of infection with genital and cutaneous human papillomavirus types (HPV) in the aetiology of ocular surface squamous neoplasia (which includes both conjunctival intraepithelial neoplasia (CIN) and carcinoma) using data and biological material collected as part of a case-control study in Uganda.ResultsAmong 81 cases, the prevalence of genital and cutaneous HPV types in tumour tissue did not differ significantly by histological grade of the lesion. The prevalence of genital HPV types did not differ significantly between cases and controls (both 38%; Odds ratio [OR] 1.0, 95% confidence interval [CI] 0.4–2.7, p = 1.0). The prevalence of cutaneous HPV types was 22% (18/81) among cases and 3% (1/29) among controls (OR 8.0, 95% CI 1.0–169, p = 0.04).ConclusionWe find no evidence of an association between genital HPV types and ocular surface squamous neoplasia. The prevalence of cutaneous HPV was significantly higher among cases as compared to controls. Although consistent with results from two other case-control studies, the relatively low prevalence of cutaneous HPV types among cases (which does not differ by histological grade of tumour) indicates that there remains considerable uncertainty about a role for cutaneous HPV in the aetiology of this tumour.

Highlights

We investigated the role of infection with genital and cutaneous human papillomavirus types (HPV) in the aetiology of ocular surface squamous neoplasia (which includes both conjunctival intraepithelial neoplasia (CIN) and carcinoma) using data and biological material collected as part of a case-control study in Uganda
Our findings demonstrate that both genital and cutaneous HPVs can be found in conjunctival tissue – the genital types were more frequently identified
We found no evidence that genital types were associated with ocular surface squamous neoplasia

Summary

Methods

Participants From November 1995 to May 2001 in country-wide clinics, anyone with a suspect corneo-conjunctival lesion was offered removal and histology, and enrolment in a followup study with home visits. HIV serology was offered after pre-test counselling. Lesions were photographed and details of the eyes and general health were recorded and analysed in EPI INFO version 6. Those who subsequently turned out to have lesions other than ocular surface squamous neoplasia were used as a control group in the analyses of HPV. Consent and ethical approval Information about the disease, its treatment and HIV testing was given in private in vernacular by counsellors, and consent confirmed by signature or thumbprint. The study was approved by the Science and Ethics Committee of the Uganda Virus Research Institute, and by the Uganda National Council for Science and Technology

Results

Discussion

Conclusion