High prevalence of HPV 16 in South African women with cancer of the cervix and cervical intraepithelial neoplasia

Abstract

Despite the high prevalence of cervical cancer and cervical neoplasias in South Africa, few studies have been performed in this region to establish which human papillomavirus (HPV) types are associated with the development of high-grade cervical intraepithelial neoplasia lesions and cervical cancer. To investigate these prevalence rates, punch biopsies were obtained from 56 women with cervical cancer and 141 women with histologically diagnosed cervical intraepithelial neoplasia 2 or 3 lesions. Nested polymerase chain reaction (PCR) using consensus degenerate PCR primers was performed for the detection of HPV DNA and HPV typing was done by restriction fragment length polymorphism. Forty-seven (94%) of the cervical cancer and 114 (88%) of the cervical intraepithelial neoplasia 2/3 biopsies were positive for HPV DNA. The prevalence rates of the HPV types detected in the cervical cancer biopsies were HPV 16 (82%), HPV 18, (10%), HPV 33 (10%), HPV 31 (2%), HPV 58 (2%), HPV 35 (2%), and HPV 59 (2%). The cervical intraepithelial neoplasia lesions contained HPV 16 (56.6%), HPV 33 (14%), HPV 31 (10.9%), HPV X (7%), HPV 52 (3.9), HPV 58 (3.1%), HPV 35 (2.3%), HPV 18 (1.6%), HPV 11 (0.8%). Five of the nine fragments that were not typed by the RFLP, designated HPV-X, were sequenced to give HPV6 (1/5), HPV 26 (2/5), HPV 68 (1/5), and candHPV 87 (1/5). HPV 58 was detected in one cervical cancer biopsy and four biopsies from cervical intraepithelial neoplasia grade 3 lesions and was shown to be a previously described variant [Williamson and Rybicki (1991) J. Med. Virol. 33:165-171]. In addition, a cervical intraepithelial neoplasia grade 2 lesion was shown to harbour HPV type HAN2294 (cand HPV 87). The results of this study indicate that cervical cancer and cervical intraepithelial neoplasia 2/3 are largely associated with HPV 16 infection in this group of South African women and, therefore, an effective HPV 16 based vaccine should prevent the development of cervical cancer in a large proportion of women from this region of South Africa.

Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

“…Previous studies have reported a high prevalence of multiple HPV infections among HIV-infected women (Palefsky et al, 1999;Gravitt et al, 2002) which is associated with an increased risk of intraepithelial neoplasia and of cancer (Moscicki et al, 2004a;Herrero et al, 2005). As was found in other African studies (Ter Meulen et al, 1992;Chabaud et al, 1996;La Ruche et al, 1998;Bayo et al, 2002;Kay et al, 2003), HPV-16 and -18 were less common than other HR-HPV types overall, but they were involved in 64% of HSIL lesions, while 93% of women with HSIL had viruses related to the HPV-16 or HPV-18 phylogenetic groups. Therefore, administration of a bivalent HPV-16/18 vaccine in this population before they get exposed might have the potential to prevent the majority of highgrade lesions in this population, but this would need to be determined in prospective studies.…”

The contribution of HPV18 to cervical cancer is underestimated using high-grade CIN as a measure of screening efficiency

“…The increased prevalence of HPV18 in cervical cancer compared to CIN2/3 as found in our study is in agreement with a recent meta-analysis and data from Australia, South Africa and the US (Clifford et al, 2003;Kay et al, 2003;Zuna et al, 2004). The sample size of our study was slightly low, because CIN2/3 and SCC cases were collected from one restricted geographical area.…”

HPV genotypes in women with squamous intraepithelial lesions and normal cervixes participating in a community-based microbicide study in Pretoria, South Africa

“…However, the most prevalent genotypes in HSILs were HPV-35 followed by 58 and 66, which differ from a previous study conducted in South Africa by Kay et al, in Cape Town, and other studies, where the most prevalent genotypes in HSILs were HPV-16 and 18. 8,4,9 This difference could represent regional variations and differences in the populations studied. The present study population was women participating in a vaginal microbicide study, who were women from the community without any specific risk factors other than the high HIV prevalence in this community, which was reported to be 25%.…”