HPV genotypes in women with squamous intraepithelial lesions and normal cervixes participating in a community-based microbicide study in Pretoria, South Africa

Abstract

a b s t r a c tBackground: Little is known regarding the human papillomaviruses (HPV) genotypes prevalent in women in South Africa, a country with a high incidence of cervical cancer.Objective: To determine the prevalence and HPV genotypes in women with squamous abnormalities and normal cervixes participating in a community-based microbicide study. Study design: A total of 159 cervical specimens, including 56 specimens from women with abnormal cytology (cases) and 103 randomly selected specimens from women with normal cytology (controls), were collected. HPV was detected by consensus PCR primers and HPV genotypes were determined by Roche Linear Array ® HPV genotyping assay. Results: HPV genotypes were found in 91% of cases and 40% of controls (p < 0.005). High-risk HPV was detected in all high-grade squamous intraepithelial lesions (HSILs), 69% of low-grade squamous intraepithelial lesions (LSILs), 57% of atypical squamous cells of undetermined significance (ASCUS), and 86% of ASCUS in which HSIL could not be excluded (ASCUS-H), and 73% of HPV positive controls. HPV-35 was the predominant genotype in HSILs; HPV-18 in ASCUS; HPV-58 in ASCUS-H and HPV-16 in LSILs and controls. Conclusion: High-risk HPV prevalence was high in both cases and controls. HPV genotype distribution in HSILs was different from that reported worldwide and from other studies in South Africa.

Age-specific prevalence of cervical human papillomavirus infection and cytological abnormalities in women in Gauteng Province

“…[17] A smaller study (N=153) from our region reported an overall HPV prevalence of 58% using the LA. [18] Snijders et al recommend that to accurately study HPV epidemiology, impact of HPV infection and monitor the efficacy of HPV vaccination programmes, the test with the highest analytical sensitivity possible must be used. [19] This shift toward highly sensitive PCR assays has affected findings in recent epidemiological studies, showing that HPV infections are more widespread than had previously been recognised.…”

“…[14] The 8 most common hrHPV types found in invasive cervical cancer (16,18,31,33,35, 45, 52, 58) as described by De Sanjose were classified as the 'top 8' .…”

“…HPV genotyping was done using the HPV linear array (LA) genotyping kit (Roche Molecular Systems, Branchburg, NJ). The pool of primers is designed to amplify HPV DNA from 15 high-risk genotypes (16,18,31,33,35 [14] The 8 most common hrHPV types found in invasive cervical cancer (16,18,31,33,35, 45, 52, 58) as described by De Sanjose were classified as the 'top 8' . [15] The overall total HPV, type-specific HPV, total hrHPV, 'top 8' hrHPV, and type 16 and/or 18, prevalence and cytology result (normal, atypical squamous cells of undetermined significance (ASCUS)), low-grade squamous intraepithelial lesion (LSIL), highgrade squamous intraepithelial lesion (HSIL) and cervical carcinoma and their 95% confidence intervals (CIs) were determined for the total study population and per age group.…”

“…[20] In the current study, the highly analytically sensitive HPV LA was used. The overall HPV and hrHPV prevalence of 74.6% and 54.3% represents the highest prevalence ever reported in a sample of the general population.HPV prevalence is described as peaking in women <25 years old, with a rapid fall in their 30s and 40s.[21] Inconsistent trends in HPV prevalence The eight most common hrHPV types found in invasive cervical cancer (16,18,31,33,35, 45, 52, 58). […”

Prevalência de lesões intraepiteliais em atipias de significado indeterminado em um serviço público de referência para neoplasias cervicais

“…Autores (11) determinaram a prevalência de HPV em 91% dos casos e o HPV de alto risco foi detectado em todas as lesões intraepiteliais de alto grau (HSIL), 69% de lesões intraepiteliais de baixo grau (SIL), 57% de células escamosas atípicas de significado indeterminado (ASCUS) e 86% células escamosas atípicas, onde não é possível excluir uma lesão intraepitelial de alto grau (ASC-H).…”