Human papilloma and other DNA virus infections of the cervix: A population based comparative study among tribal and general population in India.

Supriti Ghosh,Navya Prabhu,Deeksha Pandey,Shama Prasada Kabekkodu,Ranjitha S Shetty,Sneha D Mallya,Veena G Kamath,Kapaettu Satyamoorthy,Sanjay M Pattanshetty,Joslin D’Souza

doi:10.1371/journal.pone.0219173

Supriti Ghosh, Navya Prabhu + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0219173

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Abstract

BackgroundDespite being preventable, cervical cancer remains a major health concern among women. Persistent Human Papillomavirus (HPV) and other viral co-infections may influence cervical dysplasia. We determined and compared the prevalence and risk factors of cervical viral infections among the tribal and general population of southern coastal Karnataka, India.MethodsA population-based cross-sectional survey was conducted among 1140 and 1100 women from tribal and general population, respectively. Cervical infections with HPV, Epstein-Barr Virus (EBV), Cytomegalovirus (CMV) and Herpes-Simplex Virus (HSV) were examined using polymerase chain reactions (PCR) and DNA sequencing.ResultsHPV prevalence was higher among tribal women (40.6%) than general population (14.3%) while the prevalence of EBV (55.1%) and CMV (49.4%) were lower among tribal women than general population (74.3% and 77.5%, respectively). HSV infection was observed in tribal women only (1.8%). Among HR-HPV strains, HPV-18 was predominant among tribal population (28.3%) while, HPV-16 was predominant among the general population (9.1%). Infections were associated with age, educational status, unemployment and personal hygiene of tribal women. Phylogenetic analysis revealed that HPV-16 variants of tribal participants were closely related to non-European sublineages indicating greater risk of HPV persistence and carcinogenesis.ConclusionThe study provides a comparative estimate for DNA virus infections of the cervix among women from general as well as tribal population in this region and also reveals a different type-specific pattern of viral infection. Further research is required to delineate the role of specific interactions between multiple virus infections and their role in carcinogenesis.

Highlights

Cervical cancer is the leading cancer among women aged 15–44 years, especially in the developing countries, with human papillomavirus (HPV) infection being the key etiological factor [1]
Human Papillomavirus (HPV) prevalence was higher among tribal women (40.6%) than general population (14.3%) while the prevalence of Epstein-Barr virus (EBV) (55.1%) and CMV (49.4%) were lower among tribal women than general population (74.3% and 77.5%, respectively)
Among HR-HPV strains, HPV-18 was predominant among tribal population (28.3%) while, HPV-16 was predominant among the general population (9.1%)

Summary

Introduction

Cervical cancer is the leading cancer among women aged 15–44 years, especially in the developing countries, with human papillomavirus (HPV) infection being the key etiological factor [1]. About 5% of the women in the general population in India harbour HPV-16/18 in the cervix [2]. In spite of being an important risk factor, HPV infection alone may be insufficient to cause cervical cancer. Infection with HIV, other opportunistic pathogens and interaction with host genetic and epigenetic factors may contribute to cervical carcinogenesis [3]. Cervical cancer remains a major health concern among women. Persistent Human Papillomavirus (HPV) and other viral co-infections may influence cervical dysplasia. We determined and compared the prevalence and risk factors of cervical viral infections among the tribal and general population of southern coastal Karnataka, India

Methods

Results

Conclusion