title: Prevalence of human papillomavirus in archival samples obtained from patients with cervical pre-malignant and malignant lesions from Northeast Brazil.
abstract: BACKGROUND
  Human Papillomavirus (HPV) is considered as a necessary, but not sufficient, cause of cervical cancer. In this study, we aimed to assess the prevalence of HPV in a series of pre-malignant and malignant cervical lesion cases, to identify the virus genotypes, and to assess their distribution pattern according to lesion type, age range, and other considered variables. The samples were submitted to histopathological revision examination and analysed by polymerase chain reaction (PCR) for the presence of HPV DNA, followed by HPV typing by dot blot hybridisation.
  
  
  RESULTS
  Of the analysed samples, 53.7% showed pre-malignant cervical lesions, and 46.3% presented with cervical cancer. Most cancer samples (84.1%) were classified as invasive carcinoma. The mean age of these cancer patients was 47.3 years. The overall HPV prevalence was 82.4% in patients with pre-malignant lesions and 92.0% in the cancer patients. HPV 16 was the most prevalent type, followed by HPV 18 and 58, including both single and double infections. Double infection was detected in 11.6% of the samples, and the most common combination was HPV 16+18.
  
  
  CONCLUSIONS
  Cervical cancer appears to occur in women in a lower age range in the studied area, compared to the situation in other Brazilian regions. Furthermore, among the patients with CIN 3 and those with cancer, we observed a higher proportion of married women, women with more than one sexual partner, smokers, and individuals with less than an elementary education, relative to their counterparts.
  
  
  RESULTS
  The overall HPV prevalence was 82.4% in patients with pre-malignant lesions and 92.0% in the cervical cancer patients from Northeast Brazil. HPV 16 was the most prevalent type, followed by HPV 18 and 58. The most common double infection was HPV 16+18. Cervical cancer appears to occur in women in a lower age range in the Northeast Brazil. Among the patients with CIN 3 and those with cancer, we observed a higher proportion of married women, women with more than one sexual partner, smokers, and individuals with less than an elementary education, relative to their counterparts.
authors.affiliation: Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Av, Sen, Salgado Filho, S/N, Lagoa Nova, CEP: 59072-970, Natal, RN, Brazil. veris@cb.ufrn.br.
authors.forename: José V
authors.initials: JV
authors.lastname: Fernandes
authors.forename: Rosely V
authors.initials: RV
authors.lastname: Meissner
authors.forename: Maria Gf
authors.initials: MG
authors.lastname: Carvalho
authors.forename: Thales Aam
authors.initials: TA
authors.lastname: Fernandes
authors.forename: Paulo Rm
authors.initials: PR
authors.lastname: Azevedo
authors.forename: João S
authors.initials: JS
authors.lastname: Sobrinho
authors.forename: José Cm
authors.initials: JC
authors.lastname: Prado
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa