Abstract
BackgroundBangladesh, with a population of 160 million and nearly half being women, has the 4th highest rate of cervical carcinoma deaths in the world. It is projected that ∼500,000 of these women would die of this entirely preventable cancer by 2030. HPV vaccination is not widely offered in Bangladesh. This pilot study is designed to find out the prevalence of rare and multi-viral high-risk HPV (hrHPV) subtype(s) infection which may help strategize a large scale vaccination program in tackling cervical carcinoma in the country.MethodsForty cases of cervical High-Grade squamous intraepithelial lesion (HSIL) and Squamous cell carcinoma (SqCa) were collected. DNA was extracted from tissue representing HSIL and SqCa and multiplex PCR was run to identify all 15 hrHPV subtypes along with known positive controls.ResultsOf the total, 27 cases were biopsies/cones and 13 were hysterectomies including 5 HSIL and 35 SqCa. Infection caused by rare subtypes, hrHPV 45 and 52, were found in only two cases. Multi-subtype infection, detected in 28 % cases, was limited to HPV16/18 in all cases but one; one case showed hrHPV16/52 combination.ConclusionA remarkable homogeneity of hrHPV 16 infection is noted in women with HSIL & SqCa in this country in these limited samples. This finding is in sharp contrast to the reports from western countries of frequent multi-viral and rare subtype hrHPV infection. This pilot study suggests that a vaccination program may be highly effective in controlling cervical cancer there. A larger study, however, is required to ratify the findings.
Highlights
Bangladesh, with a population of 160 million and nearly half being women, has the 4th highest rate of cervical carcinoma deaths in the world
All but one case (N = 39) in this series were successfully amplified by multiplex PCR indicating the high-risk Human papillomavirus (HPV) (hrHPV) identification rate of 97.5 % in Squamous cell carcinoma (SqCa) and High-Grade squamous intraepithelial lesion (HSIL) specimens in this study
The current study has found that the rare hrHPV subtypes are highly uncommon in this cervical carcinoma prevalent country
Summary
Bangladesh, with a population of 160 million and nearly half being women, has the 4th highest rate of cervical carcinoma deaths in the world. HPV vaccination is not widely offered in Bangladesh This pilot study is designed to find out the prevalence of rare and multi-viral high-risk HPV (hrHPV) subtype(s) infection which may help strategize a large scale vaccination program in tackling cervical carcinoma in the country. According to a published report an estimated 6582 women per 100,000 die of cervical cancer annually (crude mortality rate of 8.7 %) [3, 4]. Persistent infection with one or more types of high-risk HPV (hrHPV) is considered crucial in disease progression from cervical intraepithelial neoplasia (CIN) to invasive carcinoma [6]. A meta-analysis of epidemiological studies designated 15 HPV types as high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) because of their significant association with progression to invasive cervical carcinoma (ICC), and additional three (26, 53, and 66) as probable high-risk types [9]
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