HPV Profile of Women in Belize City, Belize: Correlation with Cervical Cytopathologic Findings
HP Cathro, T Loya, F Dominguez, SL Howe, R Howell, J Moreno, K Orndorff, E Mendez, PC Fung, NL Beer, P Allen, AM Sosa, KK Gurka, MH Stoler, HF Frierson. University of Virginia, Charlottesville; University of California, Los Angeles; Los Angeles Department of County Health, Los Angeles; Clinica Maria Luisa Ortiz, Mulukuku, Nicaragua; Digene Corporation, Gaithersburg; University of Arizona, Tucson; Private Practice, Hermisillo, Mexico; Belize Ministry of Health, Belmopan, Belize; Karl Heusner Memorial Hospital, Belize City, Belize
Background: Cervical carcinoma is the most common cancer among Belizean women; however, data regarding the frequency of human papillomavirus (HPV) genotypes and their association with cervical cancer and intraepithelial neoplasia are non-existent. We therefore included HPV genotyping as part of a cervical cancer screening campaign conducted in Belize City in 2007.
Design: An educational program was followed by routine gynecologic examination with colposcopy and further treatment when necessary. Conventional Pap smears with Hybrid Capture (HC) 2 HPV testing were performed on 463 women. All HC2-positive samples were genotyped using a developmental GP5+/GP6+ PCR-coupled Luminex assay for 2 low-risk and 18 high-risk HPV types.
Results: 8% of Pap smears were abnormal. The prevalence of high-risk HPV was 15.6% in the total population, 10.1% in those with normal cytology (92% of the total group), and 93.3% in women with a high-grade squamous intraepithelial lesion (HSIL), (3.2% of the total group). 31.9% of patients with HPV infections had multiple types (5.0% of the total group). 5.0% of all women and 2.6% of women with normal cytology had HPV16 or 18. For all women, HPV16, 18, 56 and 52 were present in decreasing order of frequency. HPV11 was present in only one patient, and none had HPV6. HPV16 was found in 47% of HSIL; however, no case of HSIL had HPV18 or 45. HPV35 and HPV58 were the next most common types in HSIL, each occurring in 20% of cases, followed by HPV31 in 13.3%. Women <25 years had the highest HPV prevalence (30%), with a drop to less than 10% in those >44 years. HPV18 was twice as prevalent as HPV16 in women <25 years and demonstrated a steady decline with increasing age.
Conclusions: Although women <25 years old were underrepresented, these data suggest that the cervical HPV profile of Belizean women differs somewhat from that of women in the rest of Central America. These data are important with regard to the development of HPV vaccines that might be used in this region.
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 32, Wednesday Morning