Spillover of Newcastle disease virus to Himalayan Griffon vulture: a possible food-based transmission.

The Newcastle disease virus (NDV) affects wild and domesticated bird species, including commercial poultry. Although the diversity of NDV in domestic chickens is well documented, limited information is available about Newcastle disease (ND) outbreaks in other bird species. We report an annotated sequence of NDV/Vulture/Borjuri/01/22, an avirulent strain of NDV reported from Borjuri, Northeast India, in Himalayan Griffon vulture. The complete genome is 15,186 bases long with a fusion protein (F) cleavage site 112GRQGR↓L117. The phylogenetic analysis based on the F protein gene and the whole genome sequence revealed that the isolate from the vulture belongs to genotype II, sharing significant homology with vaccine strain LaSota. The study highlights the possible spillover of the virus from domestic to wild species through the food chain.

Foot-and-mouth disease-associated myocarditis is age dependent in suckling calves.

Myocarditis is considered a fatal form of foot-and-mouth disease (FMD) in suckling calves. In the present study, a total of 17 calves under 4 months of age and suspected clinically for FMD were examined for clinical lesions, respiratory rate, heart rate, and heart rhythm. Lesion samples, saliva, nasal swabs, and whole blood were collected from suspected calves and subjected to Sandwich ELISA and reverse transcription multiplex polymerase chain reaction (RT-mPCR) for detection and serotyping of FMD virus (FMDV). The samples were found to be positive for FMDV serotype "O". Myocarditis was suspected in 6 calves based on tachypnoea, tachycardia, and gallop rhythm. Serum aspartate aminotransferase (AST), creatinine kinase myocardial band (CK-MB) and lactate dehydrogenase (LDH), and cardiac troponins (cTnI) were measured. Mean serum AST, cTn-I and LDH were significantly higher (P < 0.001) in < 2 months old FMD-infected calves showing clinical signs suggestive of myocarditis (264.833 ± 4.16; 11.650 ± 0.34 and 1213.33 ± 29.06) than those without myocarditis (< 2 months old: 110.00 ± 0.00, 0.06 ± 0.00, 1050.00 ± 0.00; > 2 months < 4 months: 83.00 ± 3.00, 0.05 ± 0.02, 1159.00 ± 27.63) and healthy control groups (< 2 months old: 67.50 ± 3.10, 0.047 ± 0.01, 1120.00 ± 31.62; > 2 months < 4 months: 72.83 ± 2.09, 0.47 ± 0.00, 1160.00 ± 18.44). However, mean serum CK-MB did not differ significantly amongst the groups. Four calves under 2 months old died and a necropsy revealed the presence of a pathognomic gross lesion of the myocardial form of FMD known as "tigroid heart". Histopathology confirmed myocarditis. This study also reports the relevance of clinical and histopathological findings and biochemical markers in diagnosing FMD-related myocarditis in suckling calves.

Clostridioides difficile in food and food products of animal origin in Assam, India.

OBJECTIVE: Considering the paucity of information about food-associated Clostridioides difficile from India, a study was undertaken to establish the prevalence of C. difficile in a variety of foods of animal origin, together with molecular strain characterization and antimicrobial resistance. METHODS: A total of 235 samples comprising raw meat and meat products, fish products, and milk and milk products were screened for C. difficile. Toxin genes and other parts of PaLoc were amplified in isolated strains. The resistance pattern towards commonly used antimicrobial agents was studied by the Epsilometric test. RESULTS: C. difficile was isolated from 17(7.23%) different food samples of animal origin, including toxigenic (6) and non-toxigenic (11) isolates. In four toxigenic strains, the tcdA gene could not be detected under used conditions (tcdA-tcdB+). However, all strains had binary toxin-associated genes (cdtA and cdtB). The antimicrobial resistance was highest in non-toxigenic C. difficile isolates in food of animal origin. CONCLUSION: Meat, meat products and dry fish, but not milk and milk products were contaminated with C. difficile. Contamination rates were low with diverse toxin profiles and antibiotic resistance patterns among the C. difficile strains.

Thermostability and Immunogenicity of Genotype II Avian Orthoavulavirus (AOaV-1) Isolates from Duck (Anas platyrhynchos) and Parrot (Eclectusroratus).

Newcastle disease (ND) is a highly contagious viral disease of poultry causing significant economic losses worldwide. Vaccination is considered the most reliable approach to curb the economic menace that is ND, but the thermolabile nature of Newcastle disease virus (NDV) vaccination poses a significant threat to its protective efficacy. This study aimed to profile the thermostability of NDV isolates from duck (As/Km/19/44) and parrot (As/WB/19/91) and evaluate their immunogenic potential in chicks. Fusion protein cleavage site (FPCS) and phylogenetic analysis demonstrated the lentogenic nature of both the isolates/strains and classified them as class II genotype II NDV. The characterized NDV isolates were adapted in specific-pathogen-free (SPF) chicks by serially passaging. Biological pathogenicity assessment of chicken-adapted As/Km/19/44 (PSD44C) and As/WB/19/91 (PSP91C) revealed both the isolates to be avirulent with a mean death time (MDT) of more than 90 h and an intracerebral pathogenicity index (ICPI) ranging from 0.2 to 0.4. Both of the NDV isolates displayed varied thermostability profiles. PSD44C was the most thermostable strain as compared to PSP91C and the commercially available LaSota vaccine strain. The immunogenicity of PSD44C and LaSota was significantly higher than PSP91C. Based on these results, it is concluded that NDV isolate PSD44C is more thermostable and immunogenic when administered intraocularly without any adverse effects. Therefore, PSD44C is suitable for further research and vaccine development.

A new blocking ELISA for detection of foot-and-mouth disease non-structural protein (NSP) antibodies in a broad host range.

Large-scale monitoring of foot-and-mouth disease (FMD) in livestock is imperative in an FMD control program. Detection of antibodies against non-structural proteins (NSP) of FMD virus (FMDV) is one of the best tools to estimate the prevalence of past infection; availability of such a well-validated test is therefore essential. Using a FMDV 3B protein-specific monoclonal antibody, we have developed a new NSP antibody blocking ELISA (10H9 bELISA) and validated it on large panels of sera from different susceptible species. The diagnostic sensitivity of the ELISA was 95% with a specificity of 98%, similar to the values found using a commercial kit (PrioCHECK FMD NS test). The 10H9 bELISA can be used in a broad range of FMD susceptible species making it a very useful tool in monitoring the foot-and-mouth disease control programs by detection of virus circulation in the vaccinated populations. KEY POINTS: • A new ELISA for detection of foot and mouth disease (FMD) antibodies. • Diagnostic sensitivity of 95% and specificity of 98%. • Tested with panels of validated sera from broad host range.

A study of risk factors associated with Newcastle disease and molecular characterization of genotype XIII Newcastle disease virus in backyard and commercial poultry in Assam, India.

The continuous emergence of Newcastle disease virus (NDV) poses a persistent threat to the poultry industry. Recent increasing outbreaks of NDV in the North East region of India have highlighted the need to closely monitor and analyze the potential risk factors for Newcastle disease (ND) outbreaks. In the present study, an attempt was made to genotype the circulating Newcastle disease virus (NDV) in the backyard and commercial poultry flocks in Assam, India. Sera samples from unvaccinated backyard poultry flocks and tissue samples of ND suspected cases were collected and tested for the presence of NDV antibodies using the Haemagglutination inhibition (HI) test. A total of seven NDV isolates were analyzed from different districts of Assam, India, both genotypically and pathotypically. All isolates were characterized as virulent, carrying 112RRKQRF117 amino acid residues at the cleavage site. As determined by phylogenetic analysis, the isolates clustered with members of genotype XIII of class II NDV. Further analysis of risk factors of ND occurrence was conducted through a questionnaire survey. All the results indicated an occurrence of genotype XIII of NDV in the farms with inadequate biosecurity and farming practices.

Isolation of genotype VII avian orthoavulavirus serotype 1 from barn owl from Northeast India.

Newcastle disease virus (NDV) affects commercial poultry as well as other avian species in the wild and in captivity. Although the diversity of NDV in domestic chickens has been well understood, little light has been shed on NDV outbreaks in other avian species. We provide an annotated sequence of NDV/Owl/Guwahati/01/20, a virulent strain of NDV isolated from barn owls in captivity from Guwahati in Northeast India. The complete genome is 15,192 base pairs long with a fusion protein (F) cleavage site 112KRQKR↓F117. The isolate showed 97.67% identity with its closest match, another highly virulent strain from Indonesia isolated from vaccinated commercial chickens; however, they differ in the F cleavage site. The NDV isolate from the owl shares 83.02% and 81.88% identity with the vaccine strains R2B and LaSota, respectively. Phylogenetic analysis with F gene as well as whole-genome nucleotide sequence reveals that the NDV isolate from owl belongs to genotype VII, subgenotype VII.2, and differs significantly from all other isolates of NDV from India.

Evaluation of different antigenic preparations against necrotic enteritis in broiler birds using a novel Clostridium perfringens type G strain.

OBJECTIVE: Keeping in view, the constraints faced by the Indian broiler industry with lack of a suitable vaccine against Necrotic Enteritis (NE), a study has been proposed to explore the prevalence and detail characterization of C. perfringens type G in NE suspected broiler chicken in the process of suitable vaccine development. METHODS: Intestinal scrapings/faecal contents of NE suspected broiler chickens were screened to establish the prevalence of C.perfringens type G in broiler birds. A most pathogenic, highly resistant type G isolate of C. perfringens, bearing both tpeL and gapC gene was selected for preparation of three different vaccine formulations, and to evaluate their immunogenic potential in broiler birds. RESULTS: Screening of clinical samples of NE suspected broiler birds revealed C. perfringens type G, bearing gapC gene in 51.22% samples, of which 47.62% revealed tpeL gene. Seven of the tpeLpos type G isolates were comparatively more pathogenic for mice, of which, one exhibited multidrug resistance towards ciprofloxacin, norfloxacin, tetracycline and levofloxacin. The sonicated supernatant (SS) prepared from the selected tpeL and gapC positive isolate could maintain a significantly higher protective IgG response than toxoid and bacterin preparation from the 21st to 28thday of age in immunized birds. CONCLUSION: The additional TpeL toxin in C. perfringens type G has been proved to be an additional key biological factor in the pathogenesis of NE in broiler chickens. Considering the release of more immunogenic proteins, the SS proved to be a better immunogenic preparation against NE with a multiple immunization dose.

Meta-analysis of the prevalence of livestock diseases in North Eastern Region of India.

AIM: The study aimed to determine the overall prevalence of livestock diseases in North Eastern Region (NER) of India, through a systematic review and meta-analysis of published data. MATERIALS AND METHODS: The articles used for the study were retrieved from PubMed, J-Gate Plus, Indian Journals, and Google scholar, R open-source scripting software 3.4.3. Metafor, Meta. The Chi-square test was conducted to assess for the heterogeneity, forest plot (confidence interval [CI] plot) is a method utilized to present the results of meta-analysis, displaying effect estimate and their CIs for each study were used for searching and retrieval of livestock diseases prevalence data in India using a search strategy combining keywords and related database-specific subject terms from 2008 to 2017 in English only. RESULTS: The prevalence of various livestock diseases are foot-and-mouth disease (21%), bluetongue (28%), brucellosis in bovine (17%), brucellosis in caprine (2%), brucellosis in porcine (18%), brucellosis in sheep and goat (3%), babesiosis (6%), theileriosis (26%), porcine reproductive and respiratory syndrome (1%), porcine cysticercosis (6%), classical swine fever (31%), Porcine circovirus (43%), and Peste des petits ruminants (15%). This information helps policymakers to take appropriate measures to reduce the disease burden. CONCLUSION: This study indicates that the overall prevalence of various livestock diseases in NER of India.

Resiquimod inhibits Newcastle disease virus replication by modulating host cytokines: An understanding towards its possible therapeutics.

Newcastle disease virus (NDV) infects domestic and wild avian species with high mortality and morbidity worldwide. Although this disease is mainly controlled through NDV vaccines, alternative use of antiviral compounds is increasingly under study. Resiquimod (R-848), an imidazoquinoline compound is a potent synthetic agonist of Toll-like receptor 7 (TLR7). Until now reports regarding the adjuvant potential of resiquimod is well established against human viruses but has been less explored against avian viruses. In the present study, we have analysed the anti-NDV effect of resiquimod in chicken embryo fibroblast cells (DF-1) and embryonated chicken eggs. About 70% reduction in NDV replication was observed 48 h and 72 h post-resiquimod treatment in DF-1 cells. Furthermore, differential host genes expression was observed in resiquimod treated DF-1 cells, PBMCs, and tissue sample of chicken embryos at a different time point. Among all the analyzed genes, significant up-regulation of viperin, IFNα, IFNγ, IL-1ß, TNFα, IL18 were observed in its transcriptional level. Furthermore, resiquimod treatment showed NDV reduction in two weeks old chickens. About 61% and 38% reduction in NDV replication was observed 72 h post-infection in lungs and spleen, respectively. The study suggests the modulation of host innate immunity regulatory genes by resiquimod, which eventually modulates the NDV replication. The result of the study could be explored further to establish resiquimod as an alternative antiviral compound against NDV.

Studies on immune response to Newcastle disease virus in broiler chickens fed with Lactobacillus reuteri PIA16 isolated from the gut of indigenous chicken of Assam, India.

BACKGROUND AND AIM: The chicken gut harbors microflora which impacts the health, production performance and immune response against pathogens. Assam local chickens reared under natural conditions are known to possess high immunocompetence which may be attributable to its gut microbiota make-up. This study aimed to investigate the individual effect of two strains of Lactobacillus reuteri PIA16 isolated separately from cecum and jejunum of Assam indigenous chicken on the immunity of broiler chickens against Newcastle disease virus (NDV) when fed singly and in combination with a prebiotic. MATERIALS AND METHODS: A total of 240 birds (48 per group) were vaccinated with Lasota strain of NDV on the 5th and 21st day of age. Blood samples were collected before and after immunization against ND for the detection of humoral antibody response by hemagglutination inhibition test. The cell-mediated immune (CMI) response was estimated through response to phytohemagglutinin-P (PHA-P) and expressed as web index. RESULTS: A significant influence on the immune response to NDV was observed in all the L. reuteri PIA16 as well as mannan oligosaccharide (MOS) supplemented groups revealing higher antibody titer than the control counterpart. The CMI response revealed a better cutaneous basophilic hypersensitivity response to PHA-P in the treated groups than the control. CONCLUSION: Enhancement in immunity was perceived in the broilers fed with L. reuteri PIA16 and in combination with MOS due to the stimulation of the host's humoral and CMI response by the probiotics and prebiotics used.

A survival study of uterine cervical patients in the North East India: Hospital-cancer registry-based analysis.

BACKGROUND: Uterine cervical cancer constitutes a major proportion of cancer in females of our population. The objective of this study was to conduct a clinical study of uterine cervical cancers including their survival from hospital-cancer registry data. MATERIALS AND METHODS: Data of uterine cervical cancer patients diagnosed from January 1, 2010 to December 31, 2010 and that were treated at a regional cancer center in North East (NE) India was recruited. The cases were analyzed for age group distribution, stage, and treatment types. Survival from the date of first diagnosis and hazard ratios (HRs) was estimated. Survival probability and HRs were calculated by Kaplan-Meier method and Cox-proportional regression analysis, respectively. Active follow-up was done for the survival analysis. RESULTS: One hundred and ninety-three patients (53.4%) were included for the analysis. Median age was 48 years, 56.5% (108/193) of patients were in the age group of 45-64 years, 56.5% (109/193) were Stage II patients, radiotherapy alone was the main treatment modality in 65.8% (127/193) of cases, 5-year overall survival (OS) was 40.7%, median survival was 44 months, early staged and advanced stage patients had 47.7%, and 29.4% 5-year OS (P = 0.002), respectively, and HR for advanced stages was 1.8 (P = 0.003, confidence interval (CI) = 1.2 to 2.7). CONCLUSION: Describing the clinical characteristics and survival of uterine cervical cancer patients is important for planning and identifying the gaps for its control in the NE India.

Isolation of novel variants of infectious bursal disease virus from different outbreaks in Northeast India.

Infectious bursal disease virus (IBDV) is a highly infectious disease of young chicken that predominantly affects the immune system. In the present study, we are reporting first comprehensive study of IBDV outbreaks from the Northeastern part of India. Northeast India shares a porous border with four different countries; and as a rule any outbreak in the neighboring countries substantially affects the poultry population in the adjoining states. Nucleotide sequence analysis of the VP2 gene of the IBDV isolates from the Northeastern part of India suggested the extreme virulent nature of the virus. The virulent marker amino acids (A222, I242, Q253, I256 and S299) in the hypervariable region of the Northeastern isolates were found identical with the reported very virulent strains of IBDV. A unique insertion of I/L294V was recorded in all the isolates of the Northeastern India. The study will be useful in understanding the circulating pathotypes of IBDV in India.

Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study.

CONTEXT: Patients with advanced ovarian cancer have a poor prognosis in spite of the best possible care. Primary debulking surgery has been the standard of care in advanced ovarian cancer; however, it is associated with high mortality and morbidity rates as shown in various studies. Several studies have discussed the benefit of neoadjuvant chemotherapy in patients with advanced ovarian cancer. AIMS: This study aims to evaluate the survival statistics of the patients who have been managed with interval debulking surgery (IDS) from January 2007 to December 2009. MATERIALS AND METHODS: During the period from January 2007 to December 2009, a retrospective analysis of 104 patients who underwent IDS for stage IIIC or IV advanced epithelial ovarian cancer at our institute were selected for the study. IDS was attempted after three to five courses of chemotherapy with paclitaxal (175 mg/m(2) ) and carboplatin (5-6 of area under curve). Overall survival (OS) and progression free survival (PFS) were compared with results of primary debulking study from existing literature. OS and PFS rates were estimated by means of the Kaplan-Meier method. Results were statistically analyzed by IBM SPSS Statistics 19. RESULTS: The median OS was 26 months and the median PFS was 18 months. In multivariate analysis it was found that both OS and PFS was affected by the stage, and extent of debulking. CONCLUSIONS: Neoadjuvant chemotherapy, followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers.

Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: a comparative study between prolonged oral cyclophosphamide and oral Etoposide.

AIM: To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy. MATERIALS AND METHODS: 30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide (100 mg/day) and the other group receiving low-dose oral etoposide (50 mg/day). Results were statistically analysed by IBM SPSS Statistics 19. RESULTS: Oral etoposide was not well tolerated with grade 2 neutropenia occurring in 33.3% and grade 3 neutropenia in 6.6% and thrombocytopenia occurring in 13.3%. Oral cyclophosphamide group on the other hand was better tolerated with none of the patients having thrombocytopenia and 6.6% patients having grade 2 neutropenia. There were two complete response (15.38%) and one partial response at the end of study (7.6%) in the cyclophosphamide group whereas there was no complete response and two partial response (16.6%) in the oral etoposide group. CONCLUSION: Long-term, low-dose oral etoposide was found to be less tolerated without any significant effect with patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy in contrast to oral cyclophosphamide which was found to be effective and well-tolerated by the patients.

Prognosis of vulval cancer with lymph node status and size of primary lesion: A survival study.

INTRODUCTION: Squamous cell cancer of the vulva is a rare disease with an annual incidence of two to three per 100,000 women. Lymph node metastasis is the most important prognostic factor for the recurrence and survival in vulval carcinoma. MATERIALS AND METHODS: It is a retrospective study of 18 cases, operated in our institute from 2006 to 2009 and followed up till July, 2012. These patients were divided into two group of node positive and node negative and compared for recurrence and survival. RESULT: Ten patients had lymph node metastasis and eight had no lymph node metastasis. Recurrence rate was 40% and 12.5% in node positive and negative groups, respectively. Adjuvant radiation when given to node negative bulky tumor showed no recurrence compared to one out of two in the non-irradiated group. Survival was only 25% in node positive recurrent cases. CONCLUSION: Lymph node positivity added a great risk for future recurrence. Prophylactic radiation in node negative, bulky tumor is helpful.

Sarcomatoid carcinoma of the cervix with foci of malignant melanoma.

INTRODUCTION: Sarcomatoid squamous cell carcinoma (SSCC) is a rare malignancy of the cervix. Until date around eighteen cases of SSCC have been reported in the literature. It is an aggressive tumor with poor prognosis. The tumor usually presents at an advanced stage. Similarly, primary melanomas of the uterine cervix are rare tumors with not more than 60 cases reported in the world literature. It also has a poor prognosis. There is no reported case of sarcomatoid carcinoma with malignant melanoma. Here, we are presenting a rare case of cervical carcinoma with histopathology suggestive of SSCC with foci of malignant melanoma proven by immunohistochemistry study. CASE REPORT: The present case report is about a 42-year-old, Mrs. SR, P5 L3 D1 A1 , presented with the complaints of intermittent bleeding per vaginum since last 3 years and severe pain in the right lower limb since 1 month. On examination, there was a proliferative growth in the cervix. Her magnetic resonance imaging (MRI) showed cervical mass lesion with right parametrial extension invading the right ureter and bladder wall causing hydroureteronephrosis with contiguous bilateral pelvic nodes. There were multiple lesions in the left femur. Diagnosis of carcinoma of cervix International Federation of Gynecology and Obstetrics stage IIIB with distant metastasis was made. Histopathology report was suggestive of sarcomatoid carcinoma with foci of melanocytic melanoma. She was planned to be treated with palliative radiation. DISCUSSION: About 90% of cervical carcinomas are squamous cell carcinoma. Adenocarcinoma constitute about 3-4% of all cervical carcinomas. Other rare pathologies are lymphoma, melanoma, sarcoma and metastatic tumors. Our case is a rare combination of sarcomatoid carcinoma with foci of malignant melanoma of cervix.

Gestational trophoblastic neoplasia: A 6 year retrospective study.

AIMS AND OBJECTIVES: To study the clinical presentations of gestational trophoblastic neoplasia and its response to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 28 women of gestational trophoblastic neoplasia evaluated over a period of 6 years from January 2004 to December 2009. Patients were evaluated on the basis of their age, number of deliveries, history of abortion or molar pregnancy, and the treatment received. All patients were scored on the basis of WHO scoring system. Patients with low risk (score /=7) received multiple agent chemotherapy with EMACO regimen. After completion of chemotherapy patients were followed for a minimum of 2 years. The response to treatment was evaluated during follow-up by clinical examination, beta hCG levels and imaging as and when required. RESULTS: Out of 28 women only 27 could be evaluated, because 1 patient was lost to follow-up. Out of 27 patients, 18 patients (66.67%) achieved complete remission with the first-line chemotherapy and additional 25.92% (7/27) achieved complete remission with second line chemotherapy resulting in complete remission of 92.5% (25/27). CONCLUSION: Gestational trophoblastic neoplasia is curable if patient is properly evaluated and scored. It shows good response to chemotherapy.

Hybrid capture 2 assay based evaluation of high-risk HPV status in healthy women of north-east India.

BACKGROUND: High risk HPV (HR-HPV) testing has been recommended as an effective tool along with cytology screening in identification of cervical intraepithelial lesions (CINs) and prevention of their progress towards invasive cervical cancer. The aim of this study was to assess the HR-HPV DNA status by Hybrid Capture 2 (HC2) assay in healthy asymptomatic women of North-East India. MATERIALS AND METHODS: This study examined cervical cell samples of forty three (n=43) healthy women by HC2 assay. A High Risk HPV DNA kit (Qiagen) was used which can detect 13 high risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. RESULTS: The mean relative light units (RLU) for samples was in the range of 141-5, 94, 619. HR-HPV DNA was confirmed in 16% (7/43) of participant women samples. Among demographic and clinical parameters, menstrual irregularity (p=0.039) and infection history (p=0.028) has shown statistically significant differences between the HR-HPV-positive and negative groups. In the HR-HPV positive group, two women were confirmed for CINs after colposcopy and histopathologic examination. CONCLUSIONS: We suggest that there may be an association between irregular menstruation and infection history of the urogenital tract with HR-HPV DNA prevalence in North-East Indian asymptomatic women. HC2 assay can be a valuable tool for HR-HPV screening.

Nested multiplex PCR based detection of human papillomavirus in cervical carcinoma patients of North- East India.

BACKGROUND: Persistent infection of one or more of about 15 high-risk human papillomaviruses (HR-HPVs), most commonly HPV types 16/18, has a significant role in cervical cancer initiation and progression. There are limited data available from north-east India about HPV prevalence though this region has high incidence rates of cervical cancer. The aim of this study was to investigate the HPV genotypes prevalent in cervical cancer patients of north-east India. MATERIALS AND METHODS: We analyzed 107 cervical cancer patient samples. Nested multiplex PCR assays were employed for detection of 13 high risk and 5 low risk HPV types. RESULTS: HPV was confirmed in 105 samples. The presence of 6 'carcinogenic' HPV types, HPV-16 (88%), -18 (15%), -31(4%) ,-45 (3%), -59 (4%), -58(1%), and one non carcinogenic, HPV-6/11 (6%), was recorded. Among various demographic and clinical factors only tumour stage showed a statistically significant association with HPV type infection (P=0.019). CONCLUSIONS: We suggest that the most prevalent genotype is HPV-16 followed by HPV-18 in cervical carcinoma patients of the north-eastern region of India. Advanced tumour stage may be associated with increased possibility of harbouring multiple HPV genotypes.