Prevalence and distribution of various human papillomavirus genotypes in women with high risk for cervical carcinoma

Background: In India, cervical cancer is second most common cancer in women and is the second most common cause of death due to cancers in women. Human papillomavirus (HPV), mainly genotype 16 and 18, are responsible for most of the precancerous lesions of cervix and for cervical cancer. Therefore, it is necessary to prevent the spread of HPV infection and its early treatment to decrease cervical cancer associated morbidity and mortality. Aims of this study was to find out the prevalence and distribution of various HPV genotypes in women high risk for cervical carcinoma. To find correlation between HPV DNA test and cytology report.Methods: An observational study was done on a total of 384 women who were at a high risk for cervical cancer.  Ectocervix and endocervix samples for conventional cytology along with cervical swab collection for HPV DNA isolation were obtained from women aged 21-65 years. Multiplex real time PCR used for HPV DNA isolation and genotyping and Bethseda classification 2014 was used for reporting cytology. Statistical analysis was done using SPSS version 22 and Microsoft excel 2010 software. Data assessment was done using independent t-test, Chi-square test or Fisher’s exact test.Results: Prevalence of HPV in women high risk for cervical cancer in our study was 14.58%. Most common high-risk genotypes were HPV 18 (7.03%) followed by HPV 16 (6.51%). All genotypes except genotype 31, were more frequently seen as a single infection rather than a multiple infection. In 323 subjects which were negative for Pap smear, 31 were positive for HPV DNA showing a statistically significant result with a p value of <0.0001.Conclusions: It was analysed that infection with HPV is very common (9.60%) even in women who had a negative Pap smear test showing a positive correlation between the two tests. HPV DNA testing can improve the detection rate of cervical intraepithelial lesions.

Disseminated Histoplasmosis in an Immunocompetent Patient from a Non Endemic Region, North India: Pointers to Potential Endemicity.

Progressive Disseminated Histoplasmosis (PDH) reported worldwide is yet a rare entity in India. Although, usually associated with an underlying immunocompromised state but few reports of this disease in non- immunocompetent individuals have been surfacing in last decade. We report PDH from Himalayan state of Uttarakhand North India in an agriculturist, non immunocompromised who responded well to treatment with no evidence of recurrence of the disease. Of late a number of cases are being reported from this region, an indication that this might be a hot spot of Histoplasma capsulatum.