High-risk human papillomavirus (HPV) genotypes in Jamaican women Free

LB-122

Infection with high-risk HPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) is considered the main cause of cervical cancer. There is currently increasing interest in these genotypes because of the development of a prophylactic vaccine that targets HPV 6, 11, 16, and 18. In Jamaica, the prevalence of cervical cancer remains high at 27.6/100,000. We studied the presence of high-risk HPV genotypes in a population of Jamaican women and determined whether there were any associations with lifestyle and sexual practices. A total of 253 women were recruited for the study, 137 pregnant women aged 15-44 years recruited at their first antenatal visit to the University Hospital of the West Indies (UHWI) from August - October 2006 and 116 non-pregnant women aged 19-83 years attending a family practice in Western Jamaica from January 2003 - October 2006. After completion of a lifestyle/sexual practice questionnaire, cervical cell samples were collected from the women. HPV DNA was detected using Polymerase Chain Reaction and Reverse Line Hybridization. Data were analyzed using SPSS version 12. HPV detection was carried out on cervical cell samples from 236 women. HPV DNA was detected in 87.7% (207/236) and of these 81.2% (168/207) was positive for high-risk types. The significant difference in HPV detection previously observed using urine samples (OR, 7.8, CI, 3.6-16.8) between pregnant and non-pregnant women was not observed using cervical cells. The presence of high-risk infections approached significance (p=0.059). Multiple infections were detected in 66.9% (83/124) and 51.8% (43/83) of pregnant and non-pregnant women respectively. Logistic regression analysis confirmed an association between the presence of multiple infections and pregnancy (OR = 2.0, 95% CI, 1.18-3.38; p = 0.01). Presence of bacterial vaginosis was associated with multiple infections (OR = 3.5; CI, 1.26-9.82 p =0.017). Of the HPV positive samples, the most common high-risk HPV types were: HPV 45: 21.7%, HPV 58: 18.8%, HPV 16: 18.4%, HPV 35: 15.0%, HPV 18: 14.5%, HPV 52: 12.0%, HPV 51: 11.1%. Other high-risk types were present in frequencies of 1.4% - 7.2%. The high rates of high-risk HPV types and multiple infections are of concern and in part could explain the continued high prevalence of cervical cancer in Jamaica. The fact that HPV 45 was found to be the most prevalent genotype is in keeping with an earlier report of a high prevalence of this genotype in another Caribbean territory (Tobago) and in Jamaican UHWI colposcopy patients. These data suggest that it may be necessary to consider development of other vaccines which target these genotypes.