Distribution of Human Papillomaviruses in Women

Abstract

Objectives: To study the distribution of human papillomviruses (HPV) in women in Kuwait using hybrid capture assay and their correlation with the severity of cervical lesions based on cytological diagnosis and to establish the relationship if any between the quantity of the viral load and the degree of severity of cervical lesions. Methods: Study sample included 181 women in the age range of 20–68 years, attending the Out-Patient Department of Gynaecology of the Al-Farwaniya Hospital and six polyclinics in Kuwait during the years 1997–1998. Cervical smears were interpreted according to the modified Bethesda System. HPV DNA was detected using a chemiluminescent-based Digene hybrid capture assay. Results: Of the 181 women studied, the cytodiagnosis was as follows: normal and inflammation 139 (76.8%), atypical squamous cells of undetermined significance (ASCUS) and atypical glandular cells of undetermined significance (AGUS) 26 (14.4%) and squamous intra-epithelial lesion (SIL) 16 (8.8%). High-risk HPV DNA had a very low prevalence in women with normal and inflammation cytology, i.e. 1.4% in contrast to women with SIL lesions which had a positivity of 68.8%. ASCUS and AGUS group had 7.7% high-risk HPV DNA positivity. The quantity of viral load was directly related to the increase in the severity of the lesions. Conclusion: High-risk HPV DNA was detected in a significantly higher proportion of women with SIL lesions as compared to those with normal cytology (p < 0.0001). Furthermore, the viral load of high-risk HPV DNA was directly related to the severity of the cervical lesions, relative light unit ratios being >20 in the majority of SIL lesions.