HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia

Abstract

BackgroundCervical cancer is the second most prevalent cancer among women of child-bearing age in Ethiopia. The aim of this study was to determine human papilloma virus (HPV) genotype distribution among HIV-negative women with normal and abnormal cervical cytology results.MethodsWe investigated a consecutive of 233 HIV-negative women between December 2008 and March 2009 presenting in a Tertiary Gynecology Referral Clinic in Ethiopia. Screening was done by Pap cytology and HPV detection and genotyping method was nested PCR (direct amplification with MY09/MY11 primers, followed by nested amplification with GP5/GP6 primers) and sequencing of the nested products. Sequencing of the non-purified nested PCR products was performed following re-amplification with Big dye terminator, using the GP6 primer.ResultsOf the 233 study participants, 92 (39.5%) had abnormal cytology. All women with abnormal cervical cytology had positive HPV DNA compared to only 48.9% of those presenting with normal cytology. Of these women, the frequency of high-risk (HR)-HPV was 83.2% and its prevalence in women with abnormal cervical cytology was significantly higher than those with normal cytology (92.4% vs. 71%, p < 0.0001). The most frequent genotypes identified were HPV16 (44.1%), followed by HPV35 and HPV45 (each 6.2%), HPV31 (4.4%), HPV56 (3.7%), HPV18 and HPV59 (each 3.1%), HPV58 (2.5%) and HPV39 (1.9%). While the most common HR-HPV infections among women with normal cytology were HPV16 (20.3%), followed by HPV35 (8.7%), HPV56 and HPV58 (each 5.8%), HPV18, HPV31 and HPV39 (each 4.4%), HPV45 (2.9%) and HPV59 and HPV68 (each 1.5%), the most common HR-HPV infections in women with abnormal cytology included HPV16 (62%), followed by HPV45 (8.7%), HPV 31, HPV35 and HPV59 (each 4.4%), and HPV18, HPV52 and HPV56 (each 2.2%). We also noted low prevalence of multiple HPV infections in women with normal or abnormal cytology. Multivariable logistic analysis showed that residing in rural area (OR 3.24, 95% CI: 1.13–9.30), being multipara (OR 7.35, 95% CI: 1.78–30.38) and having abnormal cervical cytology results (OR 6.75, 95% CI: 1.78–25.57) were all independently associated with HPV16 genotype.ConclusionsOur study revealed a significant risk of infection with HR-HPV, in particular with HPV16 genotype, in women attending a referral center in Ethiopian women presenting with or without abnormal cervical cytology. Moreover, Pap smear cytology missed a significant proportion of women compared to those who were identified by PCR for HR-HPV infections. In addition, the PCR method we used was not suitable for sensitive detection of co-existent multiple infections. Data from the present study indicate that currently available HPV vaccines could prevent nearly 67% of all cervical cancer cases in women in Ethiopia.Electronic supplementary materialThe online version of this article (10.1186/s13027-018-0201-x) contains supplementary material, which is available to authorized users.

A retrospective analysis of women diagnosed with unclassified HPV genotypes

“…Similar to the present study, the most common genotype was HPV 16 in patients diagnosed with cervical cancer [13][14][15]. Annunziata et al declared that the most common unclassified genotype was HPV 81, in Italian women [4].…”

HPV genotype prevalence and distribution during 2009–2018 in Xinjiang, China: baseline surveys prior to mass HPV vaccination

“…HPV is an etiologic factor for the malignant lesions of cervix, vagina, vulva, and penis, and genital warts [4]. According to a report of the International HPV Reference Center, the HPV family is made up of 202 different genotypes [5]. Among the 202 patients, about 40 are found in the female genital tract [6] and could be divided.…”

<p>Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection in Women with Abnormal Cervical Cytology: A Population-Based Study in Shanxi Province, China</p>

“…20 The prevalence of HR-HPV in women with abnormal cervical cytology is 92.4%, significantly higher than those with normal cytology (71%). 21 In Shanxi Province in China, the prevalence of HR-HPV in normal pathology, CIN1, and CIN2+ is 11.1%, 72.5%, and 91.4%, respectively. 22 However, the distribution of HR-HPV infection varies in different countries and regions, and demographics as well as behavioral characteristics related to HR-HPV infection in women with cervical abnormalities are poorly understood.…”