title: Prevalence of human papillomavirus genotypes among women with cervical cancer in Ghana.
abstract: BACKGROUND
  Human Papillomavirus (HPV) infections have been shown to be a necessary risk factor for the development of cervical cancer. However, HPV genotype distribution varies geographically, both in type and relative prevalence. In order to ensure a successful introduction of available vaccines, there is the need to identify pre-vaccination HPV genotype prevalence in Ghana and the extent of single and multiple-infections.
  
  
  METHODS
  Paraffin-embedded cervical tissues of 256 confirmed cervical cancer cases diagnosed at the Korle-Bu Teaching Hospital during the period January 2004 to December 2006 were selected after hematoxylin and eosin staining and confirmation. Following a heat-proteinase K-based tissue lysis, HPV was detected and typed by a nested-multiplex PCR assay using an E6/E7 consensus primer and type-specific primers.
  
  
  RESULTS
  Of the 256 cases, 230 (89.8 %, 95 % CI 85.7-93.4 %) were positive for HPV DNA. HPV18 (47.4 %), HPV59 (42.2 %), HPV45 (37.4 %) and HPV16 (9.0 %) were the four common HPV genotypes detected. A total of 110 (47.8 %) of the 230 HPV DNA positive tissues, were infected by a single HPV genotype while the other 120 (52.2 %) were infected by multiple HPV genotypes. A significant association was determined between each of the following HPV genotypes and multiple-infection; HPV18 (OR = 6.97; 95 % CI, 3.89-12.50), HPV59 (OR = 9.56; 95 % CI, 5.57-20.02) and HPV45 (OR = 1.94; 95 % CI, 1.12-3.35).
  
  
  CONCLUSIONS
  The prevalence of the following high risk HPV genotypes (HPV18, HPV59, HPV45) were relatively high among the cases of cervical cancers reported at this hospital in Ghana during the study period. Additionally, there was a high frequency of HPV multiple-infections among these cases.
authors.affiliation: Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra Ghana ; Cellular and Clinical Research Centre, Radiological and Medical Science Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.
authors.forename: A K
authors.initials: AK
authors.lastname: Awua
authors.affiliation: Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra Ghana.
authors.forename: S T
authors.initials: ST
authors.lastname: Sackey
authors.affiliation: Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra Ghana.
authors.forename: Y D
authors.initials: YD
authors.lastname: Osei
authors.affiliation: Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana.
authors.forename: R H
authors.initials: RH
authors.lastname: Asmah
authors.affiliation: Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana ; Department of Pathology, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana ; University of Health and Allied Sciences, Ho, Ghana.
authors.forename: E K
authors.initials: EK
authors.lastname: Wiredu
keywords: Cervical cancer; Ghana; Human Papillomavirus; Multiplex PCR; Nested PCR; Paraffin-embedded tissues
references.citation: Int J Gynaecol Obstet. 2006 Nov;94 Suppl 1:S8-S21
references.pmid: 29644633
references.citation: J Clin Pathol. 2002 Apr;55(4):244-65
references.pmid: 11919208
references.citation: J Clin Microbiol. 2004 Jan;42(1):366-8
references.pmid: 14715780
references.citation: Clin Cancer Res. 2005 Apr 15;11(8):2919-23
references.pmid: 15837742
references.citation: BMC Public Health. 2006 Jun 20;6:159
references.pmid: 16787544
references.citation: BMC Infect Dis. 2013 May 24;13:238
references.pmid: 23706168
references.citation: BMC Infect Dis. 2010 Aug 17;10:242
references.pmid: 20716343
references.citation: N Engl J Med. 2009 Jul 16;361(3):271-8
references.pmid: 19605832
references.citation: East Afr Med J. 2000 Oct;77(10):534-8
references.pmid: 12862120
references.citation: BMC Infect Dis. 2009 Aug 10;9:124
references.pmid: 19664248
references.citation: J Histochem Cytochem. 1998 Apr;46(4):535-40
references.pmid: 9524200
references.citation: J Clin Pathol. 1991 Nov;44(11):924-7
references.pmid: 1752983
references.citation: J Clin Microbiol. 2004 Mar;42(3):1330-2
references.pmid: 15004111
references.citation: BMC Infect Dis. 2011 Nov 15;11:316
references.pmid: 22081930
references.citation: CA Cancer J Clin. 2001 Mar-Apr;51(2):92-114; quiz 115-8
references.pmid: 11577486
references.citation: Br J Cancer. 2006 Aug 7;95(3):355-62
references.pmid: 16832413
references.citation: J Clin Pathol. 2004 Jun;57(6):654-6
references.pmid: 15166276
references.citation: East Afr Med J. 2010 Aug;87(8):345-9
references.pmid: 23451558
references.citation: J Clin Microbiol. 2003 Sep;41(9):4451-3
references.pmid: 12958291
references.citation: N Engl J Med. 2003 Feb 6;348(6):518-27
references.pmid: 12571259
references.citation: Int J Cancer. 1997 Nov 27;73(5):775-6
references.pmid: 9398061
references.citation: Int J Cancer. 2014 Mar 15;134(6):1389-98
references.pmid: 23929250
references.citation: J Natl Cancer Inst Monogr. 2003;(31):3-13
references.pmid: 12807939
references.citation: CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108
references.pmid: 15761078
references.citation: Lancet. 2005 Sep 17-23;366(9490):991-8
references.pmid: 16168781
references.citation: Arch Med Res. 2004 Nov-Dec;35(6):511-6
references.pmid: 15631876
references.citation: J Clin Microbiol. 2004 Jul;42(7):3176-84
references.pmid: 15243079
references.citation: J Infect Dis. 2010 Dec 15;202(12):1789-99
references.pmid: 21067372
references.citation: Lancet. 2001 Oct 27;358(9291):1429-30
references.pmid: 11705494
references.citation: Virol J. 2011 Nov 10;8:514
references.pmid: 22074103
references.citation: Cancer. 2008 Nov 15;113(10 Suppl):2995-3003
references.pmid: 18980283