Thailand is a cervical carcinoma endemic area. Obesity, high BMI value, is known to be associated with many diseases including a high risk of cervical cancer death. In this work, a large cohort of Thai women was explored to determine the association between human papilloma virus (HPV) infection and body mass index (BMI).
HPV genotyping data from 4487 women aged from 20 to 70 year-old was collected and analyzed in a hospital-based cervical cancer screening program at Chulabhorn Hospital, Bangkok, Thailand. The kit of linear array HPV testing, capable of identifying 37 HPV types including 12 high-risk (HR), 8 probable high-risk (PR), and 17 low-risk (LR) types classified by oncogenic potentiality, was used to analyze HPV genotyping results.
From the study, 15.1%, 6.4%, 3.5% and 8.4% of the cohort were found to have HPV infection, HR, PR, and LR, respectively. The cohort with BMI 25.00-29.99 kg/m2 has significantly low Odds Ratio (OR) of 0.48, lower than that of the cohort with BMI < 18.5 kg/m2, for high-risk HPV positive type at 95% confidence interval of 0.29-0.80. The same cohort has significantly high OR of 1.49 for HPV negative at 95% confidence interval of 1.04-2.13; significantly low OR of 0.67 for HPV positive at 95% confidence interval of 0.47-0.96. The cohort with BMI ≥ 30 kg/m2 (obesity) is not found to be significantly associated with HPV infection (HPV negative, HPV positive, high-risk positive HPV, and low-risk HPV positive). However, the OR value is found to be significantly low of 0.25 for probable high-risk HPV with 95% confidence interval of 0.07-0.94.
| HPV negative | HPV positive | High-risk HPV positive | Probable-risk HPV positive | Low-risk HPV positive | |
| BMI <18.5 kg/m2 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| BMI 18.50-22.99 kg/m2 | 1.12 (0.80-1.56) | 0.90 (0.64-1.24) | 0.88(0.56-1.39) | 1.14 (0.56-2.30) | 0.90 (0.59-1.38) |
| BMI 23.00-24.99 kg/m2 | 1.06 (0.75-1.53) | 0.93 (0.65-1.34) | 0.60 (0.36-1.01) | 1.46 (0.70-3.06) | 1.01 (0.64-1.60) |
| BMI 25.00-29.99 kg/m2 | 1.49 (1.04-2.13)* | 0.67 (0.47-0.96)* | 0.48 (0.29-0.80)* | 0.90 (0.42-1.90) | 0.75 (0.47-1.18) |
| BMI >=30.00 kg/m2 | 1.49 (0.96-2.31) | 0.67 (0.43-1.04) | 0.63 (0.34-1.16) | 0.25 (0.07-0.94)* | 0.73 (0.41-1.28) |
Overweight women (BMI 25.00-29.99 kg/m2) have lower HPV high-risk positive infection than other BMI groups. High-risk HPV infection was not found to be significant in BMI of <18.50, 18.50-22.99, and 23.00-24.99 kg/m2. The low rate of HPV infection in all women in the study group is due to the widely adopted HPV vaccination for primary prevention of cervical cancer in Thailand.