High HPV-51 Prevalence in Invasive Cervical Cancers: Results of a Pre-Immunization Survey in North Sardinia, Italy

Abstract

BackgroundHuman Papilloma virus (HPV) is recognized as the etiological agent of benign and malignant ano-genital lesions. The most prevalent genotypes associated with cervical carcinoma are HPV-16 and -18 worldwide. However, recent studies have emphasized the role of other genotypes, such as HPV-51, in the pathogenesis of cervical dysplasia. The aim of the study was to estimate the burden of HPV-51 infection in invasive cervical malignant lesions in Northern Sardinia, Italy.Methods/Principal FindingsAn observational, retrospective, prevalence, mono-center study was carried out to evaluate the presence of HPV genotypes in tissues biopsies of cervical lesions (CIN-1, CIN-2, CIN-3 and invasive carcinoma) gathered from 1996 to 2009. Biological samples were collected from women admitted consecutively to a tertiary university hospital situated in Sassari, Italy. Molecular methods were used to identify 28 oncogenic HPV types. A total of 155 formalin-fixed and paraffin-embedded cervical tissue samples were analyzed. Approximately half of the cervical lesions were classified as invasive carcinoma. HPV-DNA was detected in 71% of the samples, with a higher frequency (100%) in those categorized as invasive neoplasia. Mono- or co-infections were demonstrated in 45.8% and 25.8% of the cervical samples, respectively. Overall, the most prevalent HPV types were -16 (49%) and -51 (19.4%), with an increased frequency of detection associated with the severity of the cervical lesions.Conclusions/SignificanceThis survey highlights for the first time the relevant role of HPV-51 infection in the pathogenesis of invasive cervical cancer prior to the introduction of a vaccination program. Although a selection bias could have influenced the results, other recent studies have described the impact of HPV-51. This remarkable epidemiological element should be carefully evaluated, particularly in the view of opting for preventive vaccines, whose cross-protection patterns determine their efficacy in protecting against infection from HPV types that are not included in the vaccine itself.

HPV genotypes distribution in Chlamydia trachomatis co-infection in a large cohort of women from north-east Italy

“…Although the present study provides no evidence of an association between genotypes and clinical outcome, the detection of HR-HPV56 and HR-HPV51 in this series confirms the recent Italian data that described these genotypes as the most frequent types associated with multiple infections (Agarossi et al, 2009;Carozzi et al, 2014) in which HPV51 has been shown to play a relevant role in the pathogenesis of invasive cervical cancer (Piana et al, 2013).…”

HPV prevalence and type‐distribution in cervical cancer and premalignant lesions of the cervix: A population‐based study from Northern Ireland

“…The prevalence (including HPV negative cases in the denominator) of HPV-16 was 27.6%, 39.8%, and 58.2% and HPV-18 prevalence 9.0%, 10.0%, and 7.4% in CIN I-III cases respectively [Guan et al, 2012], again higher than the estimates reported in the present study, variation which may have arisen from methodological differences in HPV detection techniques. The majority of SCCs (92.2%) in the present study were HPV positive, this is in accordance with the proportions of invasive cervical cancers (the majority of which were SCCs) testing HPV positive in other countries of the UK [Mesher et al, 2015], Sweden, Including high-risk HPV genotypes other than HPV 16/18 that is: 33,35,39,45,51,52,56,58,59,66,and 68. Spain Italy, and Eastern Europe [Du et al, 2011;Alemany et al, 2012;Giorgi Rossi et al, 2012;Guan et al, 2012;Piana et al, 2013;Pista et al, 2013;Tjalma et al, 2013;Skamperle et al, 2013;Kjaer et al, 2014;Simanaviciene et al, 2015].…”

Frequency of twelve carcinogenic human papilloma virus types among women from the South Backa region, Vojvodina, Serbia

“…These data suggest that the presence of this type could not be related to the cancer incidence in our region. However, taking into account the results of research in other regions (23,25), the confirmation of this claim requires a study on a larger number of subjects. Still, data on the prevalence of HPV51 are especially important since currently commercially available vaccines and second generation nanovalent prophylactic HPV vaccines do not protect against HPV51 (9,23).…”