title: Distribution of Human Papillomavirus Genotypes in Iranian Women According to the Severity of the Cervical Lesion.
abstract: BACKGROUND
  Persistent infection with high-risk human papillomavirus (HPV) has been recognized as a major cause of cervical cancer. Distribution of HPV genotypes may differ according to the geographic region and the severity of the cervical lesion. Determining HPV genotypes' specific distribution is useful for HPV surveillance and control programs. However, little is known about the distribution of HPV genotypes in Iranian women.
  
  
  OBJECTIVE
  The aim of this study was to determine the distribution of HPV genotypes in Iranian women with different grades of cervical lesions.
  
  
  METHODS
  From 2011 to 2013, a total of 436 Iranian women with convenience sampling strategy were included in this cross-sectional study. In detail, 287 women negative for intraepithelial lesion or malignancy, 32 with atypical squamous cells of undetermined significance (ASCUS), 50 with low-grade squamous intraepithelial lesion (LSIL), 44 with high-grade squamous intraepithelial lesion (HSIL), and 23 with cervical cancer were evaluated in this investigation. HPV genotypes were determined by INNO-LiPA HPV Genotyping Extra assay.
  
  
  RESULTS
  In total, HPV infection was detected in 45.4% of the cases. The most common high-risk HPV (HR-HPV) genotype was HPV-16 (32.8%), followed by HPV-53 (9.1%). Within low-risk (LR-HPV) genotypes HPV-6 (22.2%) and HPV-44 (6.1%) were the most prevalent. HPV-16 was the predominant genotype in cases with cervical cancer (56.5%), ASCUS (34.4%), and HSIL (34.1%). HPV-6 was the most common genotype in normal cases (9.1%) and LSIL patients (18%). The prevalence of HPV positivity was significantly higher in cases with high-grade lesions (≥ HSIL) (64.2%) than in normal/LSIL (37.3%) (P = 0.033). The rate of HR-HPV infection was significantly higher in ≥ HSIL cases (61.2%) than normal/LSIL (27.9%) (P = 0.003).
  
  
  CONCLUSIONS
  This study describes robust information on the distribution of HPV genotypes among Iranian women with and without cervical lesions. The present data may be of importance for designing future public health strategies, including HPV vaccination programs.
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Salehi-Vaziri
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Immunology and Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, IR Iran.
authors.forename: Farzin
authors.initials: F
authors.lastname: Sadeghi
authors.affiliation: Department of Gynecology Oncology ,Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Firoozeh Sadat
authors.initials: FS
authors.lastname: Hashemi
authors.affiliation: Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hayedeh
authors.initials: H
authors.lastname: Haeri
authors.affiliation: Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farah
authors.initials: F
authors.lastname: Bokharaei-Salim
authors.affiliation: Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Seyed Hamidreza
authors.initials: SH
authors.lastname: Monavari
authors.affiliation: Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
keywords: Cervical Cancer; Iran; Papillomavirus Infections