High risk human papillomavirus DNA detection in pap tests with both atypical squamous cells of undetermined significance and candida

Objective We examined the detection rate of high risk human papil-lomavirus (br-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 hr-HPV tests results were identified. The rate of hr-HPV detection in this group was compared to our laboratory's overall hr-HPV 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 ≤ 20 and 21-25 age-groups had significantly higher rates of hr-HPV detection 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 of Candida 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. copy; The International Academy of Cytology.