Abstract
Multiple human papillomavirus (HPV) genotypes often coexist within the cervical epithelia and are frequently detected together in various grades of the cervical neoplasia. To date, only a few reports exist on multiple HPV infections of HPV in Xinjiang Uygur Autonomous Region (XUAR). In the present study, we investigated the prevalence of High-Risk HPV (HR-HPV) genotypes and multiple infections. Cervical cytology samples were collected from 428 women who presented cervical abnormalities. Genotyping of HPV was performed by polymerase chain reaction–sequencing based typing (PCR-SBT) using consensus primers and specific primers. Of them, 166 samples were positive for HPV according to PCR results using the consensus primers. These samples contained cervical abnormalities enriched with inflammation (n = 107), cervical intraepithelial neoplasia (CIN) I (n = 19), CINII-III (n = 9) and cervical cancer (n = 31). Of the 166 HPV positive samples as determined by PCR analysis, 151 were further typed by PCR-SBT using 19 pairs of genotype-specific primers. Using this method, 17 different HR-HPV genotypes were identified. The most frequently observed HPV genotypes were HPV16 (44.0%, 73/166), 53 (28.9%, 48/166), 52 (25.3%, 42/166), 58 (22.3%, 37/166) and 35 (17.5%, 29/166). The proportions of single and multiple infections in the HPV-positive specimens were 34.9% and 65.1%, respectively. Multiple HPV types were most prevalent in the inflammatory state (63.0%), followed by cervical cancer (24.1%), CINI (11.1%), and CINII-III (1.9%). The results of our data analyses suggested that i) multiple HPV infection is not necessarily correlated with the severity of cervical abnormalities; and ii) among the multiple HPV infections, double infections combined with HPV16 is the most common. In addition, L1 full-length sequences of the top five high-risk HPV genotypes were amplified and sequenced. According to the L1 sequence of the epidemic genotypes that were amplified, we found that these genotypes contained the sequence point mutation, and that some of these genotypes further showed amino acid modifications. These results provide a basis for the construction of a polyvalent vaccine that is suitable for use in the XUAR, even in economically challenged communities located in China.
Highlights
Cervical cancer is the second most common malignancy among women and the leading cause of cancer-related death among females worldwide [1, 2]
With the development of molecular epidemiology, biological risk factors for abnormal cervical incidence are mainly related to human papillomavirus (HPV) infection
HPV infection in samples having a background of inflammation, CINI, CINII–II, and cervical cancer were present in 33.6%, 45.2%, 47.4%, and 63.3% of these cases, respectively, which suggested that the positive rate of HPV increased with the severity of the pathological diagnostic grade
Summary
Cervical cancer is the second most common malignancy among women and the leading cause of cancer-related death among females worldwide [1, 2]. According to epidemiological and molecular biology reports, at least 19 HPV genotypes have been identified as HR-HPV (HPV16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 70, 73 and 82) [7]. These genotypes mostly belong to oncogenic HPV, including alpha-9 (16, 31, 33, 35, 52 and 58) and alpha-7 (18, 39, 45, 59 and 68), which can cause HPV related genital tract tumors [8]. In a pooled analysis of 15 areas worldwide, the prevalence of multiple HPV infection averaged about 25% and ranged from 18.5%–46% among HPV-positive women [10,11,12]
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