Cervical Cytology and High Risk HPV Genotype Distribution in Blacks
Xiu Yang, Jonathan Somma, Raavi Gupta, Camille Ragin, Felicitas Lacbawan. SUNY Downstate Medical Center, Brooklyn; Fox Chase Cancer Center, Philadelphia
Background: Persistent infection with high-risk (HR) human papilloma-viruses (HPV) has been demonstrated as causal factor for cervical neoplasia. Molecular testing for HR HPV is now recommended as part of initial triage for women 30 years and older. Cervista™ HPV HR (HPV HR) and genotyping 16/18 (HPV 16/18) are FDA-approved HPV tests currently in clinical use. To date, literature on HR HPV distribution in Blacks is still wanting. Here we present our initial findings on the HR HPV genotype distribution among black women in Brooklyn, NY and correlate their cervical cytology results.
Design: Of 138 HPV HR positive patients from 716 total patients (19.3%) referred for HPV HR testing from January to March 2011, only 47 Blacks with sufficient remaining cervical specimens in ThinPrep solution were processed for HR HPV genotypes by HPV 16/18 and Linear Array (LA) HPV Genotyping kit (Roche). Cytology results were correlated with HPV genotype. HPV 16/18 and LA genotyping results were also compared.
Results: The 47 patients ranged from 19 to 75 years old (mean age = 42.6 yo). Twenty-one patients (44.7%) had cytology diagnosis of ASC-US and above, including 16 ASC-US (34.0%), 1 ASC-H (2%), 2 LSIL (4.3%) and 2 HSIL (4.3%). Among patients with abnormal cytology, LA HPV 59 (28.6%) and HPV 16 (23.8%) were more common. Multiple HPV genotypes were present in 19 (40.4 %) patients determined by LA tests and 14 (73.7%) had abnormal cytology. Three of 6 patients with abnormal cytology had single HPV genotype. From combined HPV 16/18 and LA genotyping, HPV 16 (19.1%) is the most frequent genotype, followed by HPV 59 (14.9%). HPV 18, 35, 39, 51 and 82 had similar prevalence, infecting 6% of this population. The infection prevalence pattern was similar in women under 30 yo and above. HPV 16 was positive in 9 patients by HPV 16/18 but only 1 was confirmed by LA. Three of 8 HPV 16 negative patients had current or previous cytology diagnosis of LSIL or HSIL. All three HPV 18 positive were confirmed by LA. The concordance between HPV HR and LA test was only 44.7% (21/47).
Conclusions: From this ongoing study, our initial results showed that abnormal cytology was associated with concurrent multiple HPV genotypes, with HPV 16 and 59 being the most prevalent. Though Brooklyn's black population is 50% Carribeans, HR HPV distribution in our cohort differs from that published on Caribbean or Caucasian US populations. However, it resembles the urban adolescent population in Georgia which is mostly African American. Furthermore, the Cervista™ HPV test is more sensitive compared to LA test in detecting HPV 16.
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 49, Tuesday Morning