title: Prevalence and genotyping of high risk human papillomavirus in cervical cancer samples from Punjab, Pakistan.
abstract: Cervical cancer is the third most common cause of cancer-related death in women worldwide. Infection with high-risk human papillomavirus (HPV) is established as the cause of cervical carcinoma, therefore, high risk HPV detection may have prognostic significance for the women who are at increased risk of disease progression. The paucity of data on the incidence of cervical cancer in Pakistan makes it difficult to determine disease burden. Even less information is available regarding the prevalent HPV strains in cervical specimens collected from this region. Cervical cancer is a neglected disease in Pakistan in terms of screening, prevention, and vaccination. Identification and accurate genotyping of the virus burden in cancer specimens is important to inform intervention policies for future management of HPV associated disease and to potentially stratify patients dependent on HPV status. In this study, detection and genotyping of HPV types 16 and 18 from 77 cervical specimens were carried out. Consensus primers GP5+/GP6+, which detect 44 genital HPV types, and type specific primers (TS16 and TS18) were used in conjunction with newly designed type specific primers. Using a combination of these methods of detection, a total of 94.81% (95% CI ±4.95) of cervical lesions were positive for HPV. Single infections of HPV16 were detected in 24.68% (95% CI ±9.63) of total samples and HPV18 was found in 25.97% (95% CI ±9.79) samples. Interestingly, a high proportion of samples (40.26%, 95% CI ±10.95) was positive for both HPV16 and 18, indicating a higher incidence of co-infection than previously reported for similar ethnic regions. The HPV genotype of 3.90% of HPV positive samples remained undetected, although these samples were positive with the GP5+/GP6+ primer set indicating infection with an HPV type other than 16 or 18. These data indicate that the overall incidence of high risk HPV infection in cervical cancer and intraepithelial neoplasia specimens in Punjab, Pakistan is in line with the worldwide prevalence, but that the incidence of HPV16 and 18 co-infections in our cohort is higher than that previously reported.
authors.affiliation: Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Sector H-12, Kashmir Highway, Islamabad 44000, Pakistan. abida.10.tfrphd.67@asab.nust.edu.pk.
authors.forename: Abida
authors.initials: A
authors.lastname: Siddiqa
authors.affiliation: Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Sector H-12, Kashmir Highway, Islamabad 44000, Pakistan. maidahzainab@gmail.com.
authors.forename: Maidah
authors.initials: M
authors.lastname: Zainab
authors.affiliation: National Center of Virology and Immunology, Islamabad 44000, Pakistan. Ishtiaq80262@yahoo.com.
authors.forename: Ishtiaq
authors.initials: I
authors.lastname: Qadri
authors.affiliation: Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Sector H-12, Kashmir Highway, Islamabad 44000, Pakistan. mfbhatti@asab.nust.edu.pk.
authors.forename: Muhammad Faraz
authors.initials: MF
authors.lastname: Bhatti
authors.affiliation: School of Cancer Sciences, Cancer Research UK Birmingham Cancer Centre, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK. j.l.parish@bham.ac.uk.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Parish
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D060085:Coinfection; D005260:Female; D005838:Genotype; D006367:HeLa Cells; D052162:Human papillomavirus 16 / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D058889:Molecular Typing; D010154:Pakistan / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology