title: Cervical cancer screening and HPV genotype distribution among asymptomatic patients of Karachi Pakistan.
abstract: BACKGROUND
  Cervical cancer is the second most prevalent cancer in females worldwide. Human papillomavirus (HPV) infection is a sexually transmitted infection. However, in addition to HPV infection, other factors exist that influence the risk of developing cervical cancer. In Pakistan most women who developed cervical cancer have been infrequently or never screened.
  
  
  OBJECTIVE
  To determine the prevalence of HPV infection and its subtype profile among asymptomatic patients with pre cancerous cervical intraepithelial lesion.
  
  
  METHODS
  In this hospital-based descriptive study, 160 asymptomatic females attending gynecology clinics were subjected to HPV screening after obtaining informed consent. Cervical Scrapings were examined by cytopathology and colposcopic directed biopsies taken. High-grade intraepithelial lesion (HSIL) CIN-2, and Low-grade intraepithelial lesion (LSIL) CIN-1 were selected. Samples were analyzed for the presence of HPV-DNA general and type specific genotype 16 and 18. HPV- DNA was extracted by QIA amp DNA kit protocol and amplification was done by polymerase chain reaction (PCR) and genotyped by type specific primers.
  
  
  RESULTS
  Out of 160, 17 Pap smear tests were positive, 6 (35.3%) with abnormal results (HSIL) CIN-2 were HPV-DNA positive. Among them, 5 (83.3%) had subtype 16 and in 1 (16.7%) case the genotype was undetectable. The remaining 11(6.9%) with pre cancer minimal abnormal (LSIL) CIN-1 presented. Out of them 3 (27.3%) were HPV-DNA positive with subtype 16. Five (45.4%) were followed by repeated pap smear every six months for two years, and the rest of 3 (27.3%) patients refused for the test.
  
  
  CONCLUSIONS
  A high incidence of Human papillomavirus (HPV) infection is found in women with pre cancerous lesion of cervix in Pakistani women.
authors.affiliation: Mubeena Shahid, MBBS, M-Phil Immunology and Infectious Disease Research Laboratory, Department of Microbiology, University of Karachi, Karachi - Pakistan.
authors.forename: Mubeena
authors.initials: M
authors.lastname: Shahid
authors.affiliation: Prof. Dr. Shahana Urooj Kazmi, PhD University of Karachi, Pakistan.
authors.forename: Shahana Urooj
authors.initials: SU
authors.lastname: Kazmi
authors.affiliation: Ameena Rehman, FCPS Civil Hospital Karachi, Pakistan.
authors.forename: Ameena
authors.initials: A
authors.lastname: Rehman
authors.affiliation: Jahanara Ainuddin, FCPS, PhD Civil Hospital Karachi, Pakistan.
authors.forename: Jahanara
authors.initials: J
authors.lastname: Ainuddin
authors.affiliation: Sayed Furqan, MCPS National Institute of Child Health, Karachi, Pakistan.
authors.forename: Sayed
authors.initials: S
authors.lastname: Furqan
authors.affiliation: Sobia Nazeer, Medical Technologist, Liaquat National Hospital, Karachi, Pakistan.
authors.forename: Sobia
authors.initials: S
authors.lastname: Nazeer
keywords: Asymptomatic; Cervix cancer; HPV genotypes; Socio-demographic factors