HPV types in cervical cancer tissue in South Africa

Abstract

Accurate identification of human papillomavirus (HPV)-types in cervical cancer tissue may be important for tailoring tests for primary screening and types to be included in a vaccine. The aim of this study was to compare test-performance of a 45-type HPV deoxyribonucleic acid (DNA)-test with a 9-type HPV messenger ribonucleic acid (mRNA)-test in cervical cancer tissues.In a case-series design 188 women with diagnosed cervical cancer during the period January 2008 to July 1, 2011 at the Gynaecological Oncology Unit, University of Pretoria, South Africa were recruited to the study. After cases with negative internal controls for DNA/mRNA detection (n = 18) and unconfirmed histology (n = 3) of cervical cancer were excluded, 167 women remained eligible for analysis. We compared 45 DNA-types detected through general primer (GP)5+/6+ polymerase chain reaction (PCR) and reverse line blot (RLB) genotyping with a modified version of the mRNA test PreTect HPV-Proofer detecting 9 genotypes (16, 18, 31, 33, 35, 45, 51, 52, 58).Histological types were 92.2% squamous cell carcinoma, 4.8% adenocarcinoma, and 3.0% adenosquamous carcinoma. Overall, HPV was detected in 95.2% (159/167) of specimens. The DNA- and mRNA tests each rendered 153/167 (91.6%) HPV positive results. When restricting the analysis to the 9 high-risk HPV-types included in the mRNA test, 91.6% (153/167) and 88.0% (147/167) were positive by the mRNA- and DNA-tests (P = .28), respectively. After hierarchical categorization of 9 comparable types, we found concordance in 66 of 67 specimens for HPV16, 25 of 27 specimens for HPV18, 19 of 21 specimens for HPV45, and only in 33 of 45 for HPV31, 33, 35, 51, 52, 58. The positivity rate for the HPV types 16, 18, and 45 and the positivity rate for HPV 16, 18, 45, 33 and 35 by both tests was 66% to 68% and 80% to 83%, respectively.Overall and when considering established high-risk types, the mRNA test has at least as high detection rate as the DNA test. The mRNA test can be an appropriate research tool to describe causative HPV-types in cervical cancer tissue for health care planning purposes.

P16 and HPV Genotype Significance in HPV-Associated Cervical Cancer—A Large Cohort of Two Tertiary Referral Centers

“…The distribution of HPV genotypes and genera among the 348 patients with HPV-associated CC is shown in Table 1 , based on the hierarchical approach described by Rad et al [ 33 ]. One or more specific genotypes were identified in 331 CCs, whereas in 17 tumors, it was not possible to identify the specific HPV type(s).…”

Age, absolute CD4 count, and CD4 percentage in relation to HPV infection and the stage of cervical disease in HIV-1-positive women

“…Similar findings of high frequency of HPV-16 genotype infection as a single infection or in mixed infections with other HPV genotypes in HIV-1-positive women with cervical disease have been reported previously in different parts of the world, namely: Brazil, [ 14 ] Burkina Faso, and South Africa in 1 study with samples from the 2 countries, [ 50 ] Cameroon, [ 51 ] South Africa, [ 9 , 38 , 52 ] and the USA. [ 53 , 54 ] Three studies; 1 from Mozambique, [ 40 ] 1 from 2 countries Kenya and South Africa, [ 55 ] and 2 from South Africa, [ 56 ] did not find the association of HIV infection and HPV-16 genotype infection. However, 2 studies; the 1 from Kenya and South Africa, and the 1 from South Africa, used cervical swabs or brushes to collect cells/tissues around the cervix for HPV testing.…”

Enhancing Cervical Cancer Prevention in South African Women: Primary HPV mRNA Screening with Different Genotype Combinations

“…The results from the two mRNA assays were utilized to evaluate test performance for detecting CIN3 disease and cervical cancer. Various combinations of HPV types, ranging from three (16,18,45) to eight (16,18,45,31,33,52,58,35), were assessed, and the subsequent impact on cervical cancer prevention was estimated based on the reported types detected in cervical cancer cases from the same hospitals [38]. The prevalence data presented by Rad et al allowed the estimation of the potential contribution of each HPV type to the development of cervical cancer.…”

“…In a prior investigation by Rad et al, the distribution of HPV types was examined in 159 women with confirmed cervical cancer and known HIV status. This cohort was drawn from the same hospitals involved in our present study [38]. Leveraging the reported South African prevalence data, we assessed the potential impact of various combinations of mRNA HPV types in primary cervical cancer screening.…”