Evidence for Possible Interaction between Human Papillomavirus and Environmental Cofactors in Women with Cervical Intraepithelial Neoplasia

ABSTRACT Although human papillomavirus (HPV) is now thought to have a major causative role in the genesis of cervical cancer, the majority of women with genital HPV infection do not develop cervical malignancy. It has, therefore, been proposed that other cofactors must be closely involved. A group of 200 women with cervical intraepithelial neoplasia (CIN) were studied for the occurrence of the proposed cofactors: herpes simplex virus (HSV), human cytomegalovirus (CMV), Chlamydia trachomatis, oral contraceptive steroids, and cigarette smoking. These women were compared with a similar group of women who had histologic evidence of HPV cervical infection only. No statistically significant differences were found between the two groups in current or previous HSV infection, current or previous C. trachomatis infection, previous CMV infection, or contraceptive usage. Women in the CIN groups who smoked were statistically significantly (p < 0.02) heavier smokers than women with HPV only who smoked. A possible dose-...