Detección del virus del papiloma humano en pacientes sin coilocitosis pero con cambios nucleares en citologías cervicales

Objective: To detect HPV DNA in patients with lack of koilocytosis but presenting nuclear changes in cervical paps and to correlate them with colposcopic features. Material and methods: HPV Consensus PCR and Line blot genotyping were used to demonstrate the presence of 27 type of HPV. Fifty consecutive cytobrushes were analyzed after the pap smear was diagnosed as normal smear but presenting nuclear changes: superficial and intermediate cells with normal cytoplasm, normal chromatin, normal o enlarged nuclei and irregularities in nuclear contour (angulations starlike) without koilocytosis). Colposcopy examination and pap smear were realized the same day. Results: HPV DNA was presented in 8 of 50 samples (16%). Six high risk HPV, 1 probably high risk and 1 low risk HPV were found. Forty eight percent (24/50) of the patients presented acetowhite lesions suggesting the presence of HPV. Conclusion: The nuclear changes found in these normal smears showed a 16% of association to HPV DNA, which it discards a direct relationship. However, 75% with HPV infection diagnosed by molecular test had acetowhite lesions suggesting the presence of HPV. This information allows us to suggest that all positive colposcopies should have an HPV test.