[Is the presence of herpesviruses in cervical secretions a prognostic factor for cervical pathology in HPV-positive women?].

Cervical carcinogenesis is a complex problem where papillomavirus is widely accepted as a causative agent. The correlation of CMV, EBV, HSV-1, HSV-2 with precancerous and cancer cervical lesions was investigated in 125 women with different diagnosis: LSIL- 44, HSIL- 12, cervical carcinoma-27 vs. 42 women without abnormality in cytology (control group). Cervical secretion samples were submitted for DNA extraction and determined by PCR and nPCR. HPV DNA genotyping was performed with the reverse hybridisation line probe assay. Among HPV-positive specimen,CMV was detected in 32% of samples, EBV in 14% and HSV-1 in 3%. The presence of CMV and EBV DNA was more frequent in cervical cancer specimen than in other study groups (p<0.001). The prevalence of EBV infection was increasing with the severity of cervical smear abnormality and was associated with HPV-16 (p=0.009). The risk for HPV-16 infection was 6.4 fold higher for CMV positive women (OR=6.44;95% CI 2.68-15.48; p=0.001) and 4.5 fold higher for EBV positive women (OR=4.58; 95% CI 1.45-14.46;p=0.009). HSV-1 and/or HSV-2 infections were detected rarely and only in the women with LSIL and in the control group. Our data suggest that EBV and/or CMV may be associated with HPV in cervical carcinogenesis.