Human papillomavirus genotypes and HPV-16 variants distribution among Tunisian women with normal cytology and squamous intraepithelial lesions

Abstract

BackgroundLittle is known about the epidemiological characteristics of papillomavirus (HPV) infection among North African countries. Herein, we conducted a molecular epidemiological study to investigate prevalence of HPV type and HPV-16 variants among cervical-screened unvaccinated Tunisian women.MethodsCross-sectional study was performed on 494 Tunisian women visiting Women’s Healthcare Centers. HPV-DNA detection was carried out on cervical samples using real-time polymerase chain reaction. HPV genotyping and HPV-16 variants were characterized by direct sequencing of L1 viral capsid gene.ResultsThe overall HPV prevalence was 34% (95% CI: 30–38%) with significantly higher prevalence among women with squamous intraepithelial lesions (SIL) than those with no intraepithelial lesions (NIL) 84% (95% CI: 76–92%) and 24.5% (95% CI: 20–29%) respectively. The distribution of HPV prevalence according to women’s age shows a U-shaped curve and the highest HPV prevalence rates were observed among the youngest (≤25 years; 51.2%, 95% CI: 37–67%) and the oldest women (>55 years; 41.7%, 95% The HPV-16 prevalence was 32.8% (95% CI: 22–45%) among women with SIL and 9.2% (95% CI: 6–12%) among women with NIL. Whereas, the HPV-18 prevalence was 1.3% (95% CI: 0–5%) among women with SIL and 0.3% (95% CI: 0–1%) among women with NIL. Among HPV-16 positive women, European lineage (E) was identified as the predominant HPV-16 variant (85.7%, 95% CI: 76–95%). The frequency of E variant was lower among SIL than among NIL women (81%, 95% CI: 64–99%, and 88%, 95% CI: 77–100%, respectively). Conversely, the African-2 variant frequency was higher among SIL than among NIL women (18%, 95% CI: 1–36% and 6%, 95% CI: 2–14%, respectively). In multivariate analysis, young age was the only risk factor that is independently associated with HPV infection. Moreover, HPV infection and menopause were both found to be independently associated with SIL and HSIL.ConclusionHPV DNA testing should be proposed to young and menopausal Tunisian women. Considering HPV prevalence, only 13% of the Tunisian women could be protected by the bivalent HPV vaccine. These results may be helpful for designing an adapted HPV testing and vaccination program in Tunisia.

Prevalence of antibodies against a cyclic peptide mimicking the FG loop of the human papillomavirus type 16 capsid among Tunisian women

“…Besides, the IgG response tended to decrease with age in women with cervical lesions and increase with age in legal sex workers, whereas the prevalence of HPV DNA detection remained the same in women with cervical lesions and decreased in legal sex workers (Figure 3). In a previous study, we found that the decrease in HPV DNA positivity with increasing age was independent of sexual activity but could be related to the development of an e cient immune response acquired with age [27,28]. Here, this theory is corroborated by the increase of anti-HPV16 IgG responses with increasing age noticed in the sex workers, as distinct from the women with cervical lesions.…”

“…Fifty-one legal sex workers were included in this study; these women were attending The Primary Care of Sousse on a monthly basis. The study population, design and epidemiological information were described previously in detail [27,28]. Eighty-ve women were randomly chosen from the general population; these women were visiting the department of gynecology of Farhat Hached Hospital for routine gynecologic examination or to receive contraceptives.…”

“…HPV DNA detection was carried out, as previously described [27]. Brie y, the presence of HPV DNA was performed using the L1 consensus degenerated primer (MY09/MY11) [28], which targets a conserved 450pb from the L1 ORF (open reading frame) and permits the detection of a large spectrum of genital HPV types. Each 20ml reaction contained 200mM of each dNTP, 10mM Tris hydrochloride (pH 8.3), 50mM potassium chloride, and 1.5mM magnesium chloride; 80pmoles of each HPV L1 consensus degenerated primer; 8pmoles of each b-globin primer and 0.5 units of Taq polymerase (Amersham, Paris, France).…”

Human Papilloma Virus Type 16 & 18 Gene Identification In Plasma of Cervical Squamous Cell Carcinoma and Adenocarcinoma Patients Athaji Adam Malik General Hospital Medan

“…HPV-16 and -18 are the most frequent causes of cervical cancer around the world, which constitute of estimated 70% of the cases, compared to other types (31, 33, 35, 45, 52, and 58) which are only around 20% 7 . No samples in this study that was infected by HPV-16, while majority (80.4%) of the samples were infected by HPV-18.…”

Genotyping of Human Papillomavirus in Cervical Squamous Intraepithelial Lesions in Mexican Women

“…Viruses belonging to the alpha-papillomavirus group infect mucosal surfaces and are found in the cervix. This genus contains 15 species (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), of which species 7 and 9 contain the genotypes HPV-18 and HPV-16, respectively. In particular, genotypes of species 9 are associated with the development of malignant lesions (1).…”