Human Papilloma Virus Types 16/18 Distribution in Invasive Cervical Cancer: An Evidence for Vaccination in Bihar, India

Abstract

There is high incidence of cervical cancer in Bihar, India. Vaccination for cervical cancer in developed countries has played a crucial role in limiting the incidence rate of cervical cancer worldwide. In consideration of debate on clinical efficacy of Human Papilloma Virus (HPV) vaccine in India, study on the prevalence of high risk HPV 16/18 strains in different regions of the nation becomes very crucial. Few individual states have started vaccination but centralised vaccination program does not exist due to lack of sufficient genotypic study of Human Papilloma Virus in different parts of India. Bihar is the third most populous state of India and HPV 16/18 distribution has not been reported yet. The nationwide data of HPV 16/18will help to develop a unified centralised vaccination program. We carried out a distribution study of high risk HPV type 16 and 18 in cervical cancer patients attending a tertiary care hospital of Bihar, India.HPV 16/18 types were analysed in cervical cancer tissues (n = 96) of patients attending the regional cancer hospital of Bihar. Tissue samples were analysed for HPV 16 and HPV 18 using a Real Time PCR technique. The results suggest very high prevalence of HPV 16/18. HPV was identified in all the samples (96/96). About, 74 (77.08%) samples presented with HPV 16 whereas, 16 (16.67%) of the samples presented with HPV 18. 6 Co-infection was presented in 6 (6.25%) of the samples of cervical cancer tissues. HPV 16/18 prevalence is more in the women aged between 41 to 61 years.We report 100% prevalence of HPV16/18 in the cervical cancer tissue samples. A way to minimise this gynaecological concern would be to introduce prophylactic vaccines and early screening in the state of Bihar. The data generated would be crucial in drafting for community screening of HPV. We strongly emphasize the prophylactic HPV Vaccination against HPV 16 to control the alarming rate of cervical cancer in one of the most populous state of India, Bihar.

Prevalence of Genotype Patterns Associated With High-Risk Human Papillomavirus in Cervical Lesions

“…A similar study reported HPV prevalence statistics in agreement with our observations that HPV16 constituted the majority (79.37%) of HPV infections followed by HPV18, 33, 31, and 45 [12]. HPV prevalence data aligning with our findings was observed in a study performed by Kumar et al, who reported a prevalence of HPV16 (77.08%) and HPV18 (16.67%) [13]. Additionally, consistent with our findings, the prevalence of 66.7% for HPV16 and 19.4% for HPV18 was reported from Andhra Pradesh [11].…”

“…Pan-India, HPV occurrence of type 16 alone is reported to be 70-90% and HPV18 prevalence generally varies from 3% to 20% [3][4][5][6][11][12][13]. In this study, while categorizing and quantifying the prevalent viral genotypes of HR-HPV, HPV16 emerged as the most prevalent type (68.65%) whereas the prevalence of HPV18 was 24.62%.…”

“…Similarly, in 36.84% of HPV-positive females in West Bengal [12], the prevalence of HPV16 with 18 was 79.37% compared to other HPV types (20.63%). A prevalence of HPV16 (77.08%) and HPV18 (16.67%) was reported by Kumar et al [13] in Bihar. These variations are linked to the diverse socioeconomic and geoclimatic conditions in specified areas.…”

“…The epidemiological spread of HPV infection and its associated genotypes, as documented in various studies [10][11][12][13][14], exhibit notable variations, influenced by diverse factors such as geographic location, socioeconomic status, cultural practices, and genetic variability of the viral genome. Additionally, intrinsic individual factors such as age, gender, anatomical site, and health condition contribute to the morbidity and mortality associated with HPV infections [15][16][17].…”

“…Reports from studies [3][4][5][6][11][12][13][14] conducted in various regions of India indicate significant differences in the prevalence of HPV infection and the pattern of genotype distribution. HR-HPV prevalence in patients with cervical cancer was 87.8% in Andhra Pradesh with the pattern of genotypes reported as HPV16 (66.7%), HPV18 (19.4%), HPV33 (5.6%), HPV35 (5.6%), HPV45 (5.6%), HPV52 (2.8%), HPV58 (2.8%), HPV59 (2.8%), and HPV73 (2.8%) [11].…”