Screening for human papillomavirus [HPV] in Egyptian females by the second-generation hybrid capture [HC II] test

ABSTRACT

Human Papillomavirus [HPV] infection is the main cause of cervical cancers and cervical intraepithelial neoplasias [CIN] worldwide. Consequently, it would be useful to evaluate HPV testing to screen for cervical cancer. Recently developed, the second-generation Hybrid Capture [HC II] test is a non-radioactive, relatively rapid, liquid hybridization assay designed to detect 18 HPV types, divided into high and low-risk groups. This test has an additional advantage, as it is also designed to provide quantitative estimates of the viral load .The aim of the present work, is to detect the rate of HPV infection and its various genotypes among the attendants of Kasr El Aini out patient gynecology clinic, using a non-invasive approach and to provide quantitative estimates of viral load. We evaluated 166 Egyptian females for HPV infection with the HC II test. The mean age of the participants was 37.28 +/- 9.16 years. According to cytology, the females were classified into normal cytology, chronic nonspecific cervicitis and squamous intraepithelial lesions [SILs]. The overall prevalence of HPV DNA in the studied groups was 15.06% [25/166], ranging from 6.6% [7/106] in normal cytology to 18% [9/50] in chronic nonspecific cervicitis to 90% [9/10] in squamous intraepithelial lesions. Among the 25 HPV- positive women, 16 [64%] were infected with high-risk HPV types, 4[16%] were infected with low risk HPV types, while 5[20%] had both types. Twenty-one [84%] of the infected woman harbored at least one high risk HPV type while 9[36%] harbored at least one low risk HPV type. Values of HPV viral load for low risk HPV infecton showed no significant difference for normal and chronic nonspecific cervicitis. But when HPV viral load of high risk HPV infecton was compared in normal, chronic nonspecific cervicitis and SIL a significant difference was found between normal and chronic nonspecific cervicitis, and between chronic nonspecific cervicitis and SIL and between normal and SIL, suggesting an association between viral load and risk of SIL and accordingly risk of cancer. Mixed HPV infection gave high viral load values even in normal smears. The viral load was apparently higher in SIL. From this study we may conclude that HPV testing using HC II assay is a useful tool when combined with cytology in diagnosing high-risk HPV viral types in apparently normal tissues. This may decrease greatly the increasing referral rate for colposcopy. This will reduce the cost services and could contribute to cancer prevention. Thus, this test may facilitate the detection of silent carriers of HPV by a sensitive noninvasive technique; leading to the identification of Egyptian women at risk of cervical neoplasia