Abstract
BackgroundAlthough analysis of the Human papillomavirus (HPV) genotype spread in a particular area has a crucial impact on public health and prevention programmes, there is a lack of epidemiological data regarding HPV in the Calabria region of Italy. We therefore update information on HPV age/genotype distribution by retrospectively analysing a cohort of women, with and without cervical lesions, living in Calabria, who underwent HPV DNA testing; moreover, we also evaluated HPV age/genotype distribution in a subset of patients with cervical lesions.MethodsCervical scrape specimens obtained from 9590 women (age range 20–75 years) from January 2010 to December 2015 were tested for HPV DNA. Viral types were genotyped by Linear Array HPV Genotyping® test (Roche, USA) at the Clinical Microbiology Operative Unit of six hospitals located in four provinces of the Calabria region.Cervical scrape specimens were also used to perform Pap smears for cytological analysis in a subset of 405 women; cytological classification of the samples was performed according to the Bethesda classification system.ResultsA total of 2974 women (31%) (C.I. 95% 30.09–31.94) were found to be HPV DNA positive for at least one (57.3%) or several (42.7%) HPV genotypes. Of single genotype HPV infections, 46.5% and 36.4 % were classed as high-risk (HR, Group 1) and low-risk (LR, Group 3) respectively, while 16.9% were classed as probably/possibly carcinogenic and 0.2% undetermined risk. Stratified by age, total HPV distribution, showed the highest prevalence within the range 30–39 years (37.2%), while single genotype infection distribution displayed a peak in women from the age range 20–29 years (37.5%). The most common high-risk HPV type was HPV 16 (19.1%), followed by HPV 31 (9.1%).ConclusionsWe provide epidemiological data on HPV age/genotype distribution in women living in the Calabria region with or without cytological abnormalities, further to the enhancement of HPV screening/prevention programmes for the local population.
Highlights
Analysis of the Human papillomavirus (HPV) genotype spread in a particular area has a crucial impact on public health and prevention programmes, there is a lack of epidemiological data regarding HPV in the Calabria region of Italy
For all samples DNA extraction was performed by an automated method using EasyMag; eluted DNA was used for Polymerase Chain Reaction (PCR) amplification of a 450-bp fragment from the L1 HPV region, using primer PGMY09/11, by Linear Array HPV Genotyping Test (LA) (Roche, USA) [13]
Single infections from High risk (HR) HPV Group 1, HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 or 59, were observed in 792 women (46.5% of those infected); infections with Low risk (LR) HPV Group 3 or indeterminate risk, HPV 6, 11, 40, 42, 54, 55, 61, 62, 72, 81, 83, 84; CP6108, 71; or IS39, were detected in 625 women (36.6%), while HR HPV Group 2A/2B infections, HPV 26, 66, 53, 67, 70, 73, 82 or 68, were observed in 288 women (16.9%)
Summary
Analysis of the Human papillomavirus (HPV) genotype spread in a particular area has a crucial impact on public health and prevention programmes, there is a lack of epidemiological data regarding HPV in the Calabria region of Italy. HPV16 and HPV18 are known to be powerful carcinogens, but an International Agency for Research on Cancer (IARC) working group has classified a total of twelve, evolutionarily linked HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) as presenting a high risk of carcinogenesis to humans (Group I). Based upon their phylogenetic relatedness, other types were classified as possible (Group 2B) or probable carcinogens (Group 2A) [3]. Epidemiological studies, carried out in different Italian regions [7,8,9], on the prevalence of HPV in women with normal cervix or cytological abnormalities have confirmed HPV 16 as the most frequent high-risk genotype identified in all neoplastic and non-neoplastic conditions
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