There is a high prevalence of human papillomavirus infection in American Indian women of the Northern Plains.
OBJECTIVE
Cervical cancer is the leading gynecological malignancy worldwide, and the incidence of this disease is very high in American Indian women. Infection with the human papillomavirus (HPV) is responsible for more than 95% of cervical squamous carcinomas. Therefore, the main objective of this study was to analyze oncogenic HPV infections in American Indian women residing in the Northern Plains.


METHODS
Cervical samples were collected from 287 women attending a Northern Plains American Indian reservation outpatient clinic. DNA was extracted from the cervical samples and HPV-specific DNA was amplified by polymerase chain reaction (PCR) using the L1 consensus primer sets. The PCR products were hybridized with the Roche HPV Line Blot assay for HPV genotyping to detect 27 different low- and high-risk HPV genotypes. The Chi-squared test was performed for statistical analysis of the HPV infection and cytology diagnosis data.


RESULTS
Of the total 287 patients, 61 women (21.25%) tested positive for HPV infection. Among all HPV-positive women, 41 (67.2%) were infected with high-risk HPV types. Of the HPV infected women, 41% presented with multiple HPV genotypes. Additionally, of the women infected with oncogenic HPV types, 20 (48.7%) were infected with HPV16 and 18 and the remaining 21 (51.3%) were infected with other oncogenic types (i.e., HPV59, 39, 73). Women infected with oncogenic HPV types had significantly higher (p=0.001) abnormal Papanicolaou smear tests (Pap test) compared to women who were either HPV negative or positive for non-oncogenic HPV types. The incidence of HPV infection was inversely correlated (p<0.05) with the age of the patients, but there was no correlation (p=0.33) with seasonal variation.


CONCLUSIONS
In this study, we observed a high prevalence of HPV infection in American Indian women residing on Northern Plains Reservations. In addition, a significant proportion of the oncogenic HPV infections were other than HPV16 and 18.
Cancer Biology Research Institute, Sanford Research, Sanford School of Medicine, The University of South Dakota, Sioux Falls, SD, USA.
Maria C
MC
Bell
Delf
D
Schmidt-Grimminger
Sarah
S
Patrick
Tim
T
Ryschon
Laurie
L
Linz
Subhash C
SC
Chauhan
D000293:Adolescent; D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D009693:Nucleic Acid Hybridization; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014412:Tumor Virus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears
D004279:DNA, Viral