[Human papillomavirus cervical @entity281 : viral genotyping and risk factors for high-grade squamous XXXX ].

@entity1 @entity75 @entity5 @entity2622 @entity281 @entity1800 @entity1799
PURPOSE: to analyze the characteristics of @entity1800 and the risk factors for high-grade squamous @entity75 and @entity2622 in @entity1 with cervical @entity281 . METHODS: a case-control study was conducted on @entity1 with cervical HPV at a Gynecology reference service enrolled at the Public Health System, located in Recife, Northeastern Brazil. The groups of cases (72 @entity1 with high-grade squamous @entity5 ) and controls (176 @entity1 with normal Pap smear or benign alterations) were investigated for six viral genotypes ( @entity1799 , 18, 31, 33, 6, 11) in ecto- and endocervical material using MY09/MY11 primers. The independent variables were ranked in three levels of determination: distal (sociodemographic), intermediate (behavioral) and proximal (previous Pap smear). The homogeneity of proportions was tested (  2), unadjusted Odds Ratios (OR) were obtained and hierarchical logistic regression was applied to the final model, with adjustment of the effect of each variable to the outcome based on the variables in the same and previous levels of causality. RESULTS: the viral genotype of cervical @entity281 was identified in 76.6% of the 248 @entity1 participating in the study. High-risk HPV genotypes (83.4% of cases and 67.1% of controls) were predominant, especially @entity1799 and 31. The distal risk factors identified were: living in a rural area (OR=2.71, 95%CI: 1.18-6.23), less than three years of study (OR=3.97, 95%CI: 2.09-7.54) and family income below two minimum wages (OR=3.30, 95%CI: 1.04-10.51); intermediate: four or more pregnancies (OR=2.00, 95%CI: 1.06-3.76); and proximal: absence of a previous Pap smear (OR=9.74, 95%CI: 2.48-38.28). CONCLUSIONS: genotypes 16 and 31 of cervical @entity281 are predominant among @entity1 assisted by the Public Health System in Northeastern Brazil. Socioeconomic and reproductive factors, as well as the absence of cytological screening, represent risk factors for the progression of @entity281 to high-grade squamous @entity5 .
