RESUMO
Background. Persistent infection with high-risk human papillomavirus (HR-HPV) has been demonstrated to be the necessary causal factor for developing cervical cancer. To know the most prevalent HR-HPV in different geographical areas is important to design diagnostic tests and implementation of vaccines. Objectives. The goal of this study is to evaluate the prevalence of HR-HPV in a total of 1001 patients, 198 with normal cytology results, 498 with low-grade squamous intraepithelial lesion (LSIL), and 205 with high-grade squamous intraepithelial lesion (HSIL) who attended our gynaecology department for opportunistic screening of HPV infection. Study design. Cervical samples were taken in a PreservCyt vial (Cytyc Corporation, Boxborough, MA). Hybrid capture assay was carried out following the manufacturer's instructions (Digene Corp., Gaithersburg, MD). All samples were further studied with polymerase chain reaction (PCR) (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany). Results. Genotype 16 was the most prevalent HR-HPV in the three groups, 17.8% in the patients with normal cytology results, 22.3% in the LSIL group, and 60% in the HSIL group. Genotype 18 had a very low prevalence in all groups. Other HR-HPV genotypes such as genotype 31, genotype 58 and genotype 52 were found in significant numbers in HSIL patients. Discussion. Our data show that genotypes 16, 31, 58, and 52 are the most prevalent HR-HPV in cervical samples with severe intraepithelial lesion in Spain. There may be some geographical variation in prevalence of carcinogenic types, and it must be considered for designing diagnostic tests and vaccine.
RESUMO
INTRODUCTION: This study investigates the relationship between various human papillomavirus (HPV) genotypes and the results of cytological and histological analysis of cervical samples using two complementary assays for HPV detection (hybrid capture and PCR). We studied the impact of HPV genotype on the presence of pre-cancerous cervical lesions and cervical cancer, as well as the association between HPV viral load and the presence of high-risk HPV as determined by PCR. METHODS: A total of 272 women were studied. Most of them presented cellular alterations consistent with cervical lesions due to HPV and all had high-risk HPV as detected by hybrid capture testing. Histological studies were undertaken, and HPV genotyping by PCR based on microarrays was performed. RESULTS: HPV-DNA was not detected or genotypes could not be identified by PCR in 22.06% of the patients. Genotype 16 and/or 18 was detected in 33% of 212 patients. Mixed infections with several genotypes were found in 25% of patients. The histological lesions associated with the various genotypes were as follows: genotype 16 and/or 18. were detected in 55.73% of the 61 patients with H-SIL and cancer, whereas these genotypes were detected in only 7.9% and 22% of women with ASCUS and L-SIL (P < 0.05). Viral load was less than 3 pg/mL in 12.13% of the women studied. In this group of patients, high-risk HPV was present in 39.39%. In the group of patients who had a viral load greater than 3 pg/mL, high risk-HPV was detected in 77.4% (P < 0.05). CONCLUSIONS: Genotypes 16 and/or 18 were detected in most patients with a diagnosis of H-SIL. Other high-risk-HPV genotypes were much less prevalent. Hybrid capture testing is a useful screening test. PCR was effective for identifying genotypes 16 and 18. Histological and cytological findings in cervical samples should be interpreted together with high-risk HPV detection.