title: Human papillomavirus prevalence and type-distribution in women with cervical lesions: a cross-sectional study in Sri Lanka.
abstract: BACKGROUND
  Cervical cancer ranks second among all cancers reported in Sri Lankan women. This study assessed the prevalence and type-distribution of human papillomavirus (HPV) among Sri Lankan women with invasive cervical cancer (ICC) and pre-cancerous lesions.
  
  
  METHODS
  114 women aged 21 years and above, hospitalized in the National Cancer Institute, Sri Lanka with a diagnosis of ICC or cervical intraepithelial neoplasia (CIN) 2/3 were prospectively enrolled between October 2009 and September 2010 (110430/NCT01221987). The cervical biopsy or excision specimens collected during routine clinical procedures were subjected to histopathological review. DNA was extracted from samples with a confirmed histological diagnosis and was amplified using polymerase chain reaction and HPV DNA was detected using Enzyme Immuno Assay. HPV positive samples were typed using reverse hybridization Line Probe Assay.
  
  
  RESULTS
  Of the cervical samples collected, 93.0% (106/114) had a histologically confirmed diagnosis of either ICC (98/106) or CIN 2/3 (8/106). Among all ICC cases, squamous cell carcinoma was diagnosed in the majority of women (81.6% [80/98]). HPV prevalence among ICC cases was 84.7% (83/98). The HPV types most commonly detected in ICC cases with single HPV infection (98.8% [82/83]) were HPV-16 (67.3%) and HPV-18 (9.2%). Infection with multiple HPV types was recorded in a single case (co-infection of HPV-16 and HPV-59).
  
  
  CONCLUSIONS
  HPV was prevalent in most women with ICC in Sri Lanka; HPV-16 and HPV-18 were the predominantly detected HPV types. An effective prophylactic vaccine against the most prevalent HPV types may help to reduce the burden of ICC disease.
authors.forename: Kanishka
authors.initials: K
authors.lastname: Karunaratne
authors.forename: Himali
authors.initials: H
authors.lastname: Ihalagama
authors.forename: Saman
authors.initials: S
authors.lastname: Rohitha
authors.forename: Anco
authors.initials: A
authors.lastname: Molijn
authors.forename: Kusuma
authors.initials: K
authors.lastname: Gopala
authors.affiliation: GlaxoSmithKline Vaccines, Wavre, Belgium. johannes.e.schmidt@gsk.com.
authors.forename: Johannes E
authors.initials: JE
authors.lastname: Schmidt
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Datta
authors.forename: Shailesh
authors.initials: S
authors.lastname: Mehta
mesh_terms: D000328:Adult; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D052162:Human papillomavirus 16; D052161:Human papillomavirus 18; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D013188:Sri Lanka / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology