High Risk Human Papillomavirus DNA Detection in Pap Tests with Both Atypical Squamous Cells of Undetermined Significance and Candida

Abstract

OBJECTIVE: We examined the detection rate of high risk human papillomavirus (hr-HPV) DNA in ThinPrep Pap tests with concurrent diagnoses of atypical squamous cells of undetermined significance (ASCUS) and fungal organisms morphologically consistent with Candida species. STUDY DESIGN: Gynecologic cytology records were searched to find reports with concurrent diagnoses of both ASCUS and Candida infection. Over a 19-month period, 309 cases with reflex brhHPV tests results were identified. The rate of hr-HPV detection in this group was compared to our laboratory's overall brhHPV rate for women in general and among 5-year age groupings. RESULTS: There was a significantly higher overall rate of hr-HPV detection in cases of ASCUS with Candida (44.7%, p < 0.001) compared to the overall ASCUS hr-HPV rate (34.1%). When age was stratified, the ASCUS with Candida < or = and 21-25 age-groups had significantly higher rates of hr-HPVde tection compared to the overall ASCUS rates (65.0% vs. 58.5, p < 0.001 and 61.6% vs. 50. 5, p < 0.04, respectively). CONCLUSION: Our study shows that the presence ofCa ndida does not exclude hr-HPV and that atypical cytologic features in the presence of Candida should not be entirely attributed to reactive cellular changes, especially in younger women.