Can human papillomavirus (HPV) genotyping classify non-16/18 high-risk HPV infection by risk stratification?

Abstract

ObjectiveInfection with high-risk genotypes of human papillomavirus (HR-HPV) is the major cause of invasive cervical cancers. HPV-16 and HPV-18 are known to be responsible for two-thirds of all invasive cervical carcinomas, followed by HPV-45, -31, and -33. Current guidelines only differentiate HPV-16/18 (+) by recommending direct colposcopy for treatment. We tried to evaluate whether there are differences in risk among 12 non-16/18 HR-HPV genotypes in this study.MethodsThe pathology archive database records of 1,102 consecutive gynecologic patients, who had results for cervical cytology and histology and for HPV testing, as determined by HPV 9G DNA chip, were reviewed.ResultsAmong the 1,102 patients, 346 were non-16/18 HR-HPV (+) and 231 were HPV-16/18 (+). We calculated the odds ratios for ≥cervical intraepithelial neoplasia 2 (CIN 2) of 14 groups of each HR-HPV genotype compared with a group of HR-HPV (–) patients. Based on the odds ratio of each genotype, we divided patients with non-16/18 HR-HPV genotypes (+) into two groups: HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+). The age-adjusted odds ratios for ≥CIN 2 of the HPV-31/33/35/45/52/58 (+) and HPV-39/51/56/59/66/68 (+) groups compared with a HR-HPV (–) group were 11.9 (95% CI, 7.6 to 18.8; p<0.001) and 2.4 (95% CI, 1.4 to 4.3; p<0.001), respectively, while that of the HPV-16/18 (+) group was 18.1 (95% CI, 11.6 to 28.3; p=0.003).ConclusionThe 12 non-16/18 HR-HPV genotypes can be further categorized (HPV-31/33/35/45/52/58 vs. HPV-39/51/56/59/66/68) by risk stratification. The HPV-31/33/35/45/52/58 genotypes might need more aggressive action. Large scale clinical trials or cohort studies are necessary to confirm our suggestion.

Incidence of cervical high‐grade squamous intraepithelial lesions and squamous cell carcinoma in women with high‐risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype

“…A 5‐year study by Uijterwaal et al found that non‐HPV 16/18‐positive women with normal cytology also had an 11.4% HSIL risk. Sung et al also found that some of the 12 non‐HPV16/18 genotypes has are associated with the same risk of HSIL as HPV16/18. Thus, the patients with non‐HPV16/18 infection should be referred to colposcopy.…”

Comparison of the PANArray HPV Genotyping Chip Test with the Cobas 4800 HPV and Hybrid Capture 2 Tests for Detection of HPV in ASCUS Women

“…According to HPV 9G DNA chip results, the odds ratios for worse than or equal to high grade squamous intraepithelial lesions (≥HSIL) of patients infected with HPV 16/18, HPV 31/33/35/45/52/58, and HPV 39/51/56/59/66/68, compared with HR HPV negative, were 18.1, 11.9, and 2.4, respectively. 18 …”

Caracterização e relação de leveduras do gênero Candida isoladas das mucosas oral e vaginal de mulheres com lesões causadas por HPV de alto risco para câncer do colo do útero

“…Os genotipos são divididos em "tipo de alto risco", onde se encaixam os conhecidos como oncogênicos (genotipos 16, 18, 31,33, 35, 39, 45, 51, 52, 58 entre outros), e em "tipo de baixo risco" que geralmente causam lesões benignas, como os genotipos 6,11,40,42,43,44 (Cordel et. al., 2015;Sung et. al., 2016;.…”

“…Os Papilomavírus Humano são vírus capazes de infectar a pele ou as mucosas. Atualmente, são conhecidos mais de 150 tipos de HPV e cerca de 40 destes possuem afinidade pelo epitélio escamoso do trato genital inferior, que é composto pelo colo, vulva, corpo do períneo, região perianal e anal (INCA, 2016;Sung et al, 2016).…”

“…Pelo menos 13 tipos de HPV são considerados oncogênicos, apresentando maior risco ou probabilidade de provocar infecções persistentes e estar associados a lesões precursoras. Dentre os HPV de alto risco oncogênico, os tipos 16 e 18 estão presentes em 70% dos casos do câncer do colo do útero (Coser et al, 2016;INCA, 2016;Sung et al, 2016).…”