Human Papillomavirus Infection and Associated Risk Factors in Indigenous and Urban Women from Cañar Province, Ecuador

Abstract

Background:There are few studies about the circulation of Human Papillomavirus (HPV) in Ecuadorian women from Cañar province.Objective: To determine HPV infection, circulating genotypes, viral load of the most frequent genotypes, intraepithelial cervical lesions and other cervical damages. Also, some social demographic, clinical and epidemiological behavior and its association with viral infection were analyzed.Methods: Two groups of Ecuadorian women were included, indigenous from rural region and urban women, both from Cañar province. A descriptive cross-sectional study was conducted from July 2017 to September 2018. Two hundred endocervical cytological samples were collected from both women populations between 15 and 55 years of age, residing in this province. Samples were analyzed by Papanicolaou test and mucosal cells were submitted to DNA extraction and subsequently HPV detection and genotyping using a commercial kit CLART® HPV 2 (Genomic, Spain). The viral load from more frequent genotypes was determined by qPCR using the commercial kit HPV Genotypes 14 Real-TM Quant (Sacace, Biotechnologies Srl. Italy). Results:Overall, infection frequency of HPV was 42.5% (85/200) with a predominance of oncogenic types, with a higher prevalence in women from urban area (51%). Cervical intraepithelial lesions were detected in 11% (22/200) of cases, mostly low-grade lesions (6%; 12/200). HPV31, 58, 66 and 59 were the most frequently HPV detected, however HPV16 was higher frequency in rural women. The high-risk HPV viral load was higher in urban women, except for HPV16. There were significant differences between the means of viral load values when high and low grade cervical lesions were compared. Smoking, hormonal contraceptive use, and a history of sexually transmitted infections were factors associated with viral infection (p < 0.05). Differences between risk factors were observed between rural and urban women. Conclusion:The high frequency of oncogenic HPV types detected indicates the need to incorporate the population of Cañar province into the early detection programs for cervical cancer and the vaccination program in Ecuador.

Human Papillomavirus Prevalence and Associated Factors in Indigenous Women in Ecuador: A Cross-Sectional Analytical Study

“…In our study, the prevalence of HPV and HR HPV was higher in women under 20 years of age compared to those who were older. This coincides with other studies worldwide, which also show a high peak in the group of women between 15 and 25 years old [ 34 , 40 ]. It is estimated that seven out of ten sexually active women are infected with HPV at least once in their lifetime, and 74% of new infections occur between the ages of 15 and 24 [ 41 ].…”

“…This study describes the prevalence of HPV and other STI pathogens in indigenous women in Ecuador. There is a lack of research on HPV in indigenous women in Ecuador [ 34 ]. This study focuses on the communities of Quilloac, Saraguro and Sevilla Don Bosco, where various factors such as socio-demographic, clinical characteristics, and epidemiological data were analyzed to better understand the prevalence and impact of HPV infection.…”