title: Prevalence and viral load of oncogenic human papillomavirus (HPV) in pterygia in multi-ethnic patients in the Malay Peninsula.
abstract: OBJECTIVE
  The aim of the study was to determine the prevalence of human papillomavirus (HPV) in primary and recurrent pterygia samples collected from different ethnic groups in the equatorial Malay Peninsula.
  
  
  METHODS
  DNA was extracted from 45 specimens of freshly obtained primary and recurrent pterygia from patients and from 11 normal conjunctival swabs from volunteers with no ocular surface lesion as control. The presence of HPV DNA was detected by nested PCR. PCR-positive samples were subjected to DNA sequencing to determine the HPV genotypes. Real-time PCR with HPV16 and HPV18 type-specific TaqMan probes was employed to determine the viral DNA copy number.
  
  
  RESULTS
  Of 45 pterygia samples with acceptable DNA quality, 29 (64.4%) were positive for HPV DNA, whereas all the normal conjunctiva swabs were HPV negative. Type 18 was the most prevalent (41.4% of positive samples) genotype followed by type 16 (27.6%). There was one case each of the less common HPV58 and HPV59. Seven of the samples harboured mixed infections of both HPV16 and HPV18. All the four known recurrent pterygia samples were HPV-positive, whereas the sole early-stage pterygium sample in the study was HPV-negative. There was no significant association between HPV-positive status with gender or age. A high proportion of patients from the Indian ethnic group (five of six) were HPV-positive, whereas the Malay patients were found to have higher HPV positivity than the Chinese. The viral load of HPV18 samples ranged between 2 × 10(2) and 3 × 10(4) copies per μg, whereas the viral load of HPV16 specimen was 4 × 10(1) to 10(2) copies per μg.
  
  
  CONCLUSIONS
  This report describes for the first time the quantitative measurement of HPV viral DNA for pterygium samples. The high prevalence of oncogenic HPVs in our samples suggests a possible role for HPV in the pathogenesis of pterygia. Moreover, the relatively low HPV viral load is concordant with the premalignant nature of this ocular condition.
authors.affiliation: Department of Biomedical Science, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia; Institute of Bioscience, Universiti Putra Malaysia, Serdang, Malaysia; Translational Infectious Diseases Laboratory, Centre for Translational Medicine, Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
authors.forename: Pei Pei
authors.initials: PP
authors.lastname: Chong
authors.forename: Chee Hong
authors.initials: CH
authors.lastname: Tung
authors.forename: Nurul Asyikin Bt Abdul
authors.initials: NA
authors.lastname: Rahman
authors.forename: Misako
authors.initials: M
authors.lastname: Yajima
authors.forename: Fee Wai
authors.initials: FW
authors.lastname: Chin
authors.forename: Crystale Lim Siew
authors.initials: CL
authors.lastname: Yeng
authors.forename: Eng Soon
authors.initials: ES
authors.lastname: Go
authors.forename: Cordelia M L
authors.initials: CM
authors.lastname: Chan
authors.forename: Nobuyo
authors.initials: N
authors.lastname: Yawata
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005006:Ethnicity; D015828:Eye Infections, Viral / Q000208:ethnology / Q000821:virology*; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics; D052161:Human papillomavirus 18 / Q000235:genetics; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000208:ethnology / Q000821:virology*; D015995:Prevalence; D011625:Pterygium / Q000208:ethnology / Q000601:surgery / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D019562:Viral Load
chemical_list: D004279:DNA, Viral
keywords: PCR detection; human papillomavirus; multi-ethnic; pterygia