Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala

Hong Li ,Bailey Kessing,Michael Dean,Jami Troxler,Héctor Ávila Rosas ,L H Garland ,Sarah Wagner ,Joseph F Boland ,Griselda López ,H.m Pinedo ,Víctor Argueta ,Andert Rosingh,Guillermo Villagran,Eduardo Gharzouzi,Hesler Morales,Enrique Alvirez,Julie Sawitzke,Miriam Castillo,Joël Fokom Domgue ,Sarita Polo Guerra,Heidi Mcmillen,Femke J H B Van Aerde-Van Nunen,Mark Schiffman,Roberto Orozco

doi:10.1186/s12885-018-4438-y

Abstract

BackgroundA low cost and accurate method for detecting high-risk (HR) human papillomavirus (HPV) is important to permit HPV testing for cervical cancer prevention. We used a commercially available HPV method (H13, Hybribio) which was documented to function accurately in a reduced volume of cervical specimen to determine the most prevalent HPV types and the distribution of HPV infections in over 1795 cancer-free women in Guatemala undergoing primary screening for cervical cancer by cytology.MethodsHR-HPV detection was attempted in cervical samples from 1795 cancer-free women receiving Pap smears using the Hybribio™ real-time PCR assay of 13 HR types. The test includes a globin gene internal control. HPV positive samples were sequenced to determine viral type. Age-specific prevalence of HPV was also assessed in the study population.ResultsA total of 13% (226/1717) of women tested HPV+, with 78 samples (4.3%) failing to amplify the internal control. The highest prevalence was found in younger women (< 30 years, 22%) and older ones (≥60 years, 15%). The six most common HR-HPV types among the 148 HPV+ typed were HPV16 (22%), HPV18 (11%), HPV39 (11%), HPV58 (10%), HPV52 (8%), and HPV45 (8%).ConclusionsIn this sample of cancer free women in Guatemala, HPV16 was the most prevalent HR type in Guatemala and the age-specific prevalence curve peaked in younger ages. Women in the 30-59-year age groups had a prevalence of HR-HPV of 8%, however, larger studies to better describe the epidemiology of HPV in Guatemala are needed.

Highlights

A low cost and accurate method for detecting high-risk (HR) human papillomavirus (HPV) is important to permit HPV testing for cervical cancer prevention
We determined that the H13 test give high concordance with the Qiagen HC2 and Onclarity assays, and has good clinical accuracy compared to histologic diagnosis [18]
HPV16 is the most common type found in women with cervical cancer worldwide, and is among the most common high-risk type in cancer-free women [26, 28,29,30,31,32], and the same is true in Guatemala

Summary

Introduction

A low cost and accurate method for detecting high-risk (HR) human papillomavirus (HPV) is important to permit HPV testing for cervical cancer prevention. We used a commercially available HPV method (H13, Hybribio) which was documented to function accurately in a reduced volume of cervical specimen to determine the most prevalent HPV types and the distribution of HPV infections in over 1795 cancer-free women in Guatemala undergoing primary screening for cervical cancer by cytology. There is overwhelming evidence that persistent infection with specific types of HPV is the main cause of CC [2, 3]. While prophylactic vaccination of adolescents and possibly young adults is the ultimate preventive strategy, screening will remain important for decades to come.

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Discussion

Conclusion