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Published in: Diagnostic Pathology 1/2018

Open Access 01-12-2018 | Research

Frequency of rare and multi viral high-risk HPV types infection in cervical high grade squamous intraepithelial lesions in a non-native dominant middle eastern country: a polymerase chain reaction-based pilot study

Authors: Alia Albawardi, M. Ruhul Quddus, Shamsa Al Awar, Saeeda Almarzooqi

Published in: Diagnostic Pathology | Issue 1/2018

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Abstract

Background

The incidence of abnormal cervical smears in the United Arab Emirates (UAE) is 3.6%. Data regarding specific high-risk HPV (hrHPV) genotypes are insufficient. Identification of hrHPV subtypes is essential to allow formulating effective vaccination strategies.

Methods

A total of 75 archival cervical cone biopsies with HSIL or higher lesions (2012–2016) were retrieved from a tertiary hospital, including HSIL (n = 70), adenocarcinoma in-situ (n = 1) and squamous cell carcinoma (n = 4). Five tissue sections (10-μ-thick each) were cut and DNA extracted using the QIAamp DNA FFPE Tissue Kit. GenomeMeTM’s GeneNavTM HPV One qPCR Kit was used for specific detection of HPV 16 and 18; and non-16/18 samples were typed by GenomeMeTM’s GeneNavTM HPV Genotyping qPCR Kit.

Results

Median age was 34 years (range 19–58) with 70% UAE Nationals. hrHPV detected were 16, 18, 31, 33, 35, 39, 45, 51, 52, 58, 59, 66 & 68. hrHPV testing was negative in 12% of cases. Most common types were HPV 16 (49%), HPV 31 (20%) and HPV 18 (6.6%). hrHPV 16 and/or 18 represented 56% and rare subtypes 32%. Co-infection was present in 16%. Eight cases had two-viral subtype infections and 4 cases had 3 subtype infections. Multi-viral HPV infection was limited to hrHPV 16, 18, 31 & 33 subtypes.

Conclusions

Infection by non HPV 16/18 is fairly common. A higher than expected incidence of rare subtype (20% hrHPV31) and multi-viral hrHPV (16%) were detected. This finding stresses the importance of this pilot study as currently only quadravalent vaccine is offered to control the HPV infection in the UAE population.
Literature
2.
4.
go back to reference Stoler M, et al. Tumours of the uterine cervix. In: Kurman R, Carcangiu ML, Heerington CM, Young RH, editors. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: International Agency for Reseach on Cancer; 2014. p. 189–206. Stoler M, et al. Tumours of the uterine cervix. In: Kurman R, Carcangiu ML, Heerington CM, Young RH, editors. WHO Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: International Agency for Reseach on Cancer; 2014. p. 189–206.
5.
go back to reference Ghazal-Aswad S, Gargash H, Badrinath P, Al-Sharhan MA, Sidky I, Osman N, Chan NH. Cervical smear abnormalities in the United Arab Emirates: a pilot study in the Arabian Gulf. Acta Cytol. 2006;50(1):41–7.CrossRefPubMed Ghazal-Aswad S, Gargash H, Badrinath P, Al-Sharhan MA, Sidky I, Osman N, Chan NH. Cervical smear abnormalities in the United Arab Emirates: a pilot study in the Arabian Gulf. Acta Cytol. 2006;50(1):41–7.CrossRefPubMed
6.
go back to reference Al Eyd GJ, Shaik RB. Rate of opportunistic pap smear screening and patterns of epithelial cell abnormalities in pap smears in ajman, United arab emirates. Sultan Qaboos Univ Med J. 2012;12(4):473–8.CrossRefPubMedPubMedCentral Al Eyd GJ, Shaik RB. Rate of opportunistic pap smear screening and patterns of epithelial cell abnormalities in pap smears in ajman, United arab emirates. Sultan Qaboos Univ Med J. 2012;12(4):473–8.CrossRefPubMedPubMedCentral
7.
go back to reference Maqsood F, Arif W, Iqbal S, Bajwa ZI, Ali M. Prevalence of cervical abnormalities and co-existent human papilloma virus infection in a mixed Bahraini population. Annals of KEMU. 2011;17(3):256–61. Maqsood F, Arif W, Iqbal S, Bajwa ZI, Ali M. Prevalence of cervical abnormalities and co-existent human papilloma virus infection in a mixed Bahraini population. Annals of KEMU. 2011;17(3):256–61.
8.
go back to reference Hajjaj AA, Senok AC, Al-Mahmeed AE, Issa AA, Arzese AR, Botta GA. Human papillomavirus infection among women attending health facilities in the Kingdom of Bahrain. Saudi Med J. 2006;27(4):487–91.PubMed Hajjaj AA, Senok AC, Al-Mahmeed AE, Issa AA, Arzese AR, Botta GA. Human papillomavirus infection among women attending health facilities in the Kingdom of Bahrain. Saudi Med J. 2006;27(4):487–91.PubMed
9.
go back to reference AlObaid A, Al-Badawi IA, Al-Kadri H, Gopala K, Kandeil W, Quint W, Al-Aker M, DeAntonio R. Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infect Dis. 2014;14:643.CrossRefPubMedPubMedCentral AlObaid A, Al-Badawi IA, Al-Kadri H, Gopala K, Kandeil W, Quint W, Al-Aker M, DeAntonio R. Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infect Dis. 2014;14:643.CrossRefPubMedPubMedCentral
10.
go back to reference Eghbali SS, Amirinejad R, Obeidi N, Mosadeghzadeh S, Vahdat K, Azizi F, Pazoki R, Sanjdideh Z, Amiri Z, Nabipour I, Zandi K. Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data. Virol J. 2012;9:194.CrossRefPubMedPubMedCentral Eghbali SS, Amirinejad R, Obeidi N, Mosadeghzadeh S, Vahdat K, Azizi F, Pazoki R, Sanjdideh Z, Amiri Z, Nabipour I, Zandi K. Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data. Virol J. 2012;9:194.CrossRefPubMedPubMedCentral
12.
go back to reference Monsonego J, Cox JT, Behrens C, Sandri M, Franco EL, Yap PS, Huh W. Prevalence of high-risk human papilloma virus genotypes and associated risk of cervical precancerous lesions in a large U.S. screening population: data from the ATHENA trial. Gynecol Oncol. 2015;137(1):47–54.CrossRefPubMed Monsonego J, Cox JT, Behrens C, Sandri M, Franco EL, Yap PS, Huh W. Prevalence of high-risk human papilloma virus genotypes and associated risk of cervical precancerous lesions in a large U.S. screening population: data from the ATHENA trial. Gynecol Oncol. 2015;137(1):47–54.CrossRefPubMed
16.
go back to reference Tsakogiannis D, Diamantidou V, Toska E, Kyriakopoulou Z, Dimitriou TG, Ruether IG, Gortsilas P, Markoulatos P. Multiplex PCR assay for the rapid identification of human papillomavirus genotypes 16, 18, 45, 35, 66, 33, 51, 58, and 31 in clinical samples. Arch Virol. 2015;160(1):207–14.CrossRefPubMed Tsakogiannis D, Diamantidou V, Toska E, Kyriakopoulou Z, Dimitriou TG, Ruether IG, Gortsilas P, Markoulatos P. Multiplex PCR assay for the rapid identification of human papillomavirus genotypes 16, 18, 45, 35, 66, 33, 51, 58, and 31 in clinical samples. Arch Virol. 2015;160(1):207–14.CrossRefPubMed
17.
go back to reference Quddus MR, Albawardi A, Al-Awar S, Almarzooqi SSH. Frequency of Rare and Multi Viral High-Risk HPV Subtype Infection in Cervical Squamous and Glandular Lesions in an Immigrant Dominant Middle Eastern Country: A PCR-Based Study. Mod Pathol. 2017;30(Suppl 2):305A. Quddus MR, Albawardi A, Al-Awar S, Almarzooqi SSH. Frequency of Rare and Multi Viral High-Risk HPV Subtype Infection in Cervical Squamous and Glandular Lesions in an Immigrant Dominant Middle Eastern Country: A PCR-Based Study. Mod Pathol. 2017;30(Suppl 2):305A.
19.
go back to reference Castellsagué X, Ault KA, Bosch FX, Brown D, Cuzick J, Ferris DG, Joura EA, Garland SM, Giuliano AR, Hernandez-Avila M, Huh W, Iversen OE, Kjaer SK, Luna J, Monsonego J, Muñoz N, Myers E, Paavonen J, Pitisuttihum P, Steben M, Wheeler CM, Perez G, Saah A, Luxembourg A, Sings HL, Velicer C. Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region. Papillomavirus Res. 2016;2:61–9. https://doi.org/10.1016/j.pvr.2016.03.002.CrossRefPubMedPubMedCentral Castellsagué X, Ault KA, Bosch FX, Brown D, Cuzick J, Ferris DG, Joura EA, Garland SM, Giuliano AR, Hernandez-Avila M, Huh W, Iversen OE, Kjaer SK, Luna J, Monsonego J, Muñoz N, Myers E, Paavonen J, Pitisuttihum P, Steben M, Wheeler CM, Perez G, Saah A, Luxembourg A, Sings HL, Velicer C. Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region. Papillomavirus Res. 2016;2:61–9. https://​doi.​org/​10.​1016/​j.​pvr.​2016.​03.​002.CrossRefPubMedPubMedCentral
20.
go back to reference Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, Turan HS, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using hpv testing in one million turkish women. Int J Cancer. 2017; https://doi.org/10.1002/ijc.31212. Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, Turan HS, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using hpv testing in one million turkish women. Int J Cancer. 2017; https://​doi.​org/​10.​1002/​ijc.​31212.​
21.
go back to reference Khoo SP, Bhoo-Pathy N, Yap SH, Anwar Shafii MK, Hairizan Nasir N, Belinson J, Subramaniam S, Goh PP, Zeng M, Tan HD, Gravitt P, Woo YL. Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population. Sex Transm Infect. 2017; https://doi.org/10.1136/sextrans-2017-053320. Khoo SP, Bhoo-Pathy N, Yap SH, Anwar Shafii MK, Hairizan Nasir N, Belinson J, Subramaniam S, Goh PP, Zeng M, Tan HD, Gravitt P, Woo YL. Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population. Sex Transm Infect. 2017; https://​doi.​org/​10.​1136/​sextrans-2017-053320.
25.
go back to reference Bedoya-Pilozo CH, Medina Magües LG, Espinosa-García M, Sánchez M, Parrales Valdiviezo JV, Molina D, Ibarra MA, Quimis-Ponce M, España K, Párraga Macias KE, Cajas Flores NV, Orlando SA, Robalino Penaherrera JA, Chedraui P, Escobar S, Loja Chango RD, Ramirez-Morán C, Espinoza-Caicedo J, Sánchez-Giler S, Limia CM, Alemán Y, Soto Y, Kouri V, Culasso ACA, Badano I. Molecular epidemiology and phylogenetic analysis of human papillomavirus infection in women with cervical lesions and cancer from the coastal region of Ecuador. Rev Argent Microbiol. 2017; https://doi.org/10.1016/j.ram.2017.06.004. Bedoya-Pilozo CH, Medina Magües LG, Espinosa-García M, Sánchez M, Parrales Valdiviezo JV, Molina D, Ibarra MA, Quimis-Ponce M, España K, Párraga Macias KE, Cajas Flores NV, Orlando SA, Robalino Penaherrera JA, Chedraui P, Escobar S, Loja Chango RD, Ramirez-Morán C, Espinoza-Caicedo J, Sánchez-Giler S, Limia CM, Alemán Y, Soto Y, Kouri V, Culasso ACA, Badano I. Molecular epidemiology and phylogenetic analysis of human papillomavirus infection in women with cervical lesions and cancer from the coastal region of Ecuador. Rev Argent Microbiol. 2017; https://​doi.​org/​10.​1016/​j.​ram.​2017.​06.​004.
26.
34.
go back to reference Hui Y, Manna P, Ou J, Kerley S, Zhang C, Sung CJ, Lawrence WD, Quddus MR. High-risk human papilloma virus infection involving multiple anatomic sites of the female genital tract: a multiplex real-time polymerase chain reaction-based study. Hum Pathol. 2015;46:1376–81.CrossRefPubMed Hui Y, Manna P, Ou J, Kerley S, Zhang C, Sung CJ, Lawrence WD, Quddus MR. High-risk human papilloma virus infection involving multiple anatomic sites of the female genital tract: a multiplex real-time polymerase chain reaction-based study. Hum Pathol. 2015;46:1376–81.CrossRefPubMed
36.
go back to reference Ghazal-Aswad S, Badrinath P, Sidky I, Gargash H. Colposcopy services in the United Arab Emirates. J Low Genit Tract Dis. 2006;10(3):151–5.CrossRefPubMed Ghazal-Aswad S, Badrinath P, Sidky I, Gargash H. Colposcopy services in the United Arab Emirates. J Low Genit Tract Dis. 2006;10(3):151–5.CrossRefPubMed
Metadata
Title
Frequency of rare and multi viral high-risk HPV types infection in cervical high grade squamous intraepithelial lesions in a non-native dominant middle eastern country: a polymerase chain reaction-based pilot study
Authors
Alia Albawardi
M. Ruhul Quddus
Shamsa Al Awar
Saeeda Almarzooqi
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2018
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/s13000-018-0716-x

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