Short Communication Comparison of the prevalence and distribution of human papillomavirus infection and cervical lesions between urban and native habitants of an Amazonian region of Peru

Abstract

ABSTRACT. We made a study of the prevalence of human papillomavirus (HPV) and cervix lesions in an Amazonian Bora native population (Bn) and compared it with the prevalence in an urban population in Iquitos (Iq). We also examined the distribution of HPV types among abnormal cervical smears in the Iq population. Swabs and cytologies were collected from 472 females. DNA consensus PCR, followed by direct sequencing, were used to determinate the HPV types in the swabs. Cytologies were classified based on the lesion grade. HPV prevalence was 43.9% in Iq and 35.4% in Bn. Cervix lesion prevalence was 20.0% in Iq and 0.3% in Bn. The frequency of high-risk HPV types among HPV+ females was 71.9% in Iq and 56.3% in Bn. The frequencies of low-risk and undetermined risk HPV types were 19.3/6.3% (Iq/ Bn) and 12.3/37.5% (Iq/Bn), respectively. In lesIq (women seeking cytological services with a previous cervix lesion diagnosis) the prevalence of HPV, was 72.9%. The incidence of carcinoma and high-grade squamous intraepithelial cervix lesions in lesIq were 31.2 and 18.8%, respectively. The Bn population had a lower incidence of high-risk HPV and cervix lesions. The high-risk strain HPV16 was significantly more frequent in Iq compared with Bn. lesIq high-risk HPVs were more frequent in high-grade squamous intraepithelial lesions and carcinoma. High-risk HPV16 prevalence was significantly higher than the prevalence of the other high-risk HPVs, especially in the high-grade squamous intraepithelial lesions and carcinoma.

A descriptive analysis of health practices, barriers to healthcare and the unmet need for cervical cancer screening in the Lower Napo River region of the Peruvian Amazon

“…28 Peruvian cancer statistics reflect this with a cumulative risk of women developing cervical and breast cancer before the age of 75 years as 4.3% and 2.4%, respectively. 29 Cervical cancer incidence in the LNR populations is compounded by the high proportion of high-risk HPV subtypes within the Loreto region 30 and limited knowledge of HPV transmission and its contributory role in cervical cancer across the country. 31…”

“…28 Peruvian cancer statistics reflect this with a cumulative risk of women developing cervical and breast cancer before the age of 75 years as 4.3% and 2.4%, respectively. 29 Cervical cancer incidence in the LNR populations is compounded by the high proportion of high-risk HPV subtypes within the Loreto region 30 and limited knowledge of HPV transmission and its contributory role in cervical cancer across the country. 31 Indigenous communities' experience of cancer screening programmes varies significantly between populations in regard to knowledge, practices and beliefs, 32 suggesting a need for programmes appropriately tailored to the needs of communities.…”

Papilomavírus humano e infecções do trato genital inferior em mulheres com exame colpocitológico anormal <b>[Resumo em Português]</b>

“…14 Prevalence values higher than those presented in this work were shown in Peru, where women with a previous diagnosis of cervical lesion had a 72.9% prevalence of HPV. 15 Higher HPV prevalence were observed when samples were related to invasive cervical cancer, as shown in studies conducted in nine different countries, with 90% prevalence of HPV by PCR in 1918 confirmed cases of cervical cancer. 1 Samples collected from patients with suspected viral infection who had negative results for HPV DNA indicates that PCR is a reliable diagnostic method compared to clinical examinations, as cytological and histological tests.…”

Frequency and coinfection between genotypes of human papillomavirus in a population of asymptomatic women in northern Peru

“…In the urban population, HPV-16 was the most common type in 58.5% followed by HPV-18 and HPV-31. On the contrary, in the Amazonian native community, HPV-16 was uncommon, as other unique HPV types were more frequently observed in these patients such as HPV-39, HPV-71, and HPV-96 [ 17 ]. Thus, HPV genotypes distribution can widely vary between two different close regions from the same country and changes in genotype prevalence are expected, with studies reporting an HPV-16 prevalence significant decrease in the last years after the introduction of the vaccine [ 18 – 20 ].…”