Prevalence of Human Papillomavirus Genotypes in Women with Normal and Abnormal Cervical Cytology in Iran

Introduction: HPV infection has a prime etiologic role in development and progression of cervical cancer, one ofthe most frequent forms of cancer among women in developing countries. This study was designed to determine themost prevalent HPV genotypes in women with normal and abnormal cervical cytology in Iran. Materials and
Methods:Samples from134 patients, including 127 who attended gynecology clinics and 7 with solid cervical tumors wereused. All 127 patients underwent routine Pap tests for cytological evaluation and at the same visit a sample ofcervical epithelial cells was obtained by scraping the cervix osteum. In each case HPV infection was primarily evaluatedby PCR using GP 5/6 primers and then subtyping was performed in proved infected samples with specific primersfor HPV 16, 18, 31, 33, 11 and 6. After cytological evaluation, 50 patients with abnormal Pap tests were categorizedas the abnormal group and the remaining 77 patients as the normal group.
Results: In the normal group, HPVinfection was established in 10 cases (13% infection rate), while 30 HPV positive cases were discovered in the abnormalgroup (60% infected). The most prevalent genotypes among the infected samples were HPV 16 (76%), HPV18 (12.7%)and HPV11/6 (8.5%). Moreover, all 7 tumor samples were positive for HPV general primers of which, 5 sampleswere infected with HPV 16, two were co-infected with HPV16,18 and HPV16,31 genotypes and one was infected withHPV 18.
Conclusions: Infection with HPV 16 was found to be significantly higher in abnormal group in comparisonwith normal group (42% vs. 11.6%, P value <0.005), likewise HPV18 genotypes were proved to be more prevalent inabnormal group (8% vs. 0%, P value <0.05). No significant relation between other HPV genotypes and pathologiccervical changes was obtained. According to our study high rates of infection with HPV genotypes in sexually activeIranian women makes molecular investigation for HPV16 and 18 very essential in clinical approaches to patientswith proven dysplasia in their screening tests and also for those patients with borderline (i.e. ASCUS) or incongruouspathology reports. Larger studies are required to determine the most appropriate vaccine with highest protection inIranian women.