A PCR study on the coexistence of herpes simplex virus, cytomegalovirus and human papillomavirus DNAs in cervical neoplasia

There is strong epidemiological and biological evidence that the development of squamous cell carcinoma of the cervix is a multistep process in which human papillomaviruses (HPVs) play a crucial but not total role and where the synergistic effect of herpes simplex virus (HSV) and human cytomegalovirus (HCMV) has been suggested. The presence of HPV, HSV and HCMV deoxyribonucleic acids (DNAs) was assessed by a polymerase chain reaction (PCR) in cervical biopsies obtained from 41 women with cervical neoplasia (21 high-grade cervical intra-epithelial neoplasia (CIN) and 20 squamous cell cancers) and 33 controls. Human papillomavirus 16 DNA was significantly more common in high-grade CIN (57%) and cancer (50%) than in normal cervix (9%). Herpes simplex virus and HCMV DNAs were present in 12% and 21% of normal cervices, 19% and 24% of high-grade CIN, and 25% and 25% of cancers, respectively. After adjustment for patients' age, coinfection associating high-risk HPVs (HPV 16 and/or HPV 18) and herpes viruses (HCMV and/or HSV) were observed in cervical neoplasia (odds ratio (OR) = 19.11; 95% confidence interval (CI): 2.14–170.36). Conversely, the OR for infection by HPV 16 and/or HPV 18 alone did not reach statistical significance (OR = 7.22; 95% CI: 0.85–61.16). Moreover infection by HCMV and/or HSV alone (OR = 0.89; 95% CI: 0.33–2.24) was not associated with cervical neoplasia. Our results support the role of HSV and HCMV as cofactors of HPV 16 and HPV 18 in cervical neoplasia.