HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia
Abstract Background Cervical 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. Methods We inves...
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | Infectious Agents and Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13027-018-0201-x |
| _version_ | 1818320401235705856 |
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| author | Dawit Wolday Muluken Derese Solomon Gebressellassie Bekure Tsegaye Wondwossen Ergete Yirgu Gebrehiwot Orit Caplan Dana G. Wolf Shlomo Maayan |
| author_facet | Dawit Wolday Muluken Derese Solomon Gebressellassie Bekure Tsegaye Wondwossen Ergete Yirgu Gebrehiwot Orit Caplan Dana G. Wolf Shlomo Maayan |
| author_sort | Dawit Wolday |
| collection | DOAJ |
| description | Abstract Background Cervical 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. Methods We 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. Results Of 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. Conclusions Our 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. |
| first_indexed | 2024-12-13T10:24:25Z |
| format | Article |
| id | doaj.art-5b75c9f685894d169d2da91304f9b396 |
| institution | Directory Open Access Journal |
| issn | 1750-9378 |
| language | English |
| last_indexed | 2024-12-13T10:24:25Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj.art-5b75c9f685894d169d2da91304f9b3962022-12-21T23:51:05ZengBMCInfectious Agents and Cancer1750-93782018-08-011311810.1186/s13027-018-0201-xHPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in EthiopiaDawit Wolday0Muluken Derese1Solomon Gebressellassie2Bekure Tsegaye3Wondwossen Ergete4Yirgu Gebrehiwot5Orit Caplan6Dana G. Wolf7Shlomo Maayan8Medical Biotech LaboratoryDepartment of Medical Microbiology, Parasitology and Immunology, College of Health Sciences, Addis Ababa UniversityDepartment of Medical Microbiology, Parasitology and Immunology, College of Health Sciences, Addis Ababa UniversityMedical Biotech LaboratoryDepartment of Pathology, College of Health Sciences, Addis Ababa UniversityDepartment of Obstetrics & Gynaecology, College of Health Sciences, Addis Ababa UniversityThe AIDS Center, Hadassah University Hospital - Hebrew UniversityThe AIDS Center, Hadassah University Hospital - Hebrew UniversityThe AIDS Center, Hadassah University Hospital - Hebrew UniversityAbstract Background Cervical 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. Methods We 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. Results Of 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. Conclusions Our 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.http://link.springer.com/article/10.1186/s13027-018-0201-xCervical cancerCytologyHPVGenotype distributionEthiopiaSub-Sahara Africa |
| spellingShingle | Dawit Wolday Muluken Derese Solomon Gebressellassie Bekure Tsegaye Wondwossen Ergete Yirgu Gebrehiwot Orit Caplan Dana G. Wolf Shlomo Maayan HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia Infectious Agents and Cancer Cervical cancer Cytology HPV Genotype distribution Ethiopia Sub-Sahara Africa |
| title | HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia |
| title_full | HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia |
| title_fullStr | HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia |
| title_full_unstemmed | HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia |
| title_short | HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral Clinic in Ethiopia |
| title_sort | hpv genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral clinic in ethiopia |
| topic | Cervical cancer Cytology HPV Genotype distribution Ethiopia Sub-Sahara Africa |
| url | http://link.springer.com/article/10.1186/s13027-018-0201-x |
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