A survey on the prevalence of high-risk subtypes of human papilloma virus among women with cervical neoplasia in Isfahan University of Medical Science

Background and Aim : Given the importance of epidemiological studies on the prevalence of humanpapilloma virus (HPV) and its subtypes to plan more effective strategies for cervical cancer prevention, theaim of this study was to determine the prevalence of HPV in women with cervical intraepithelial neoplasiaand cancer in IsfahanMethods : In this descriptive cross-sectional study, women referred to oncology clinic of Shahid BeheshtiHospital because of abnormal cytology of their cervices within the last year were studied. The 2001Bethesda system was used for histologic classification. The distribution of different pathologies was asfollows: squamous cell carcinoma (SCC) 34.7%, low-grade squamous intraepithelial lesions (LSIL) 30.5%,high-grade squamous intraepithelial lesions (HSIL) 22.8%, atypical squamous cell of undeterminedsignificance (ASCUS) 8.4%, and adenocarcinoma (AC) 3.3%. There was no case of atypical glandular ofundetermined significance or cases of adenocarcinoma associated with an early lesion. The presence ofHPV infection and its subtypes including HPV 16, 18, 6 and 11 was assessed in different cytologicalcategories of cervical neoplasia, by using polymerase chain reaction method.Results : During this study, 130 patients were studied. Their median age was 52 years (range 29–73 years).HPV was detected in 118/130 patients (90.8%) with abnormal cervical cytology. The prevalence of positiveHPV samples was 97.6, 80, 93.1, 92.3, and 66.6% in cases with SCC, AC, HSIL, LSIL, and ASCUS,respectively (P < 0.05 between SCC and ASCUS, HSIL and ASCUS, and LSIL and ASCUS). Out of 118cases with positive HPV, 98 (83.1%) were positive for multiple HPV types 16, 18, and 11 or 6. Thedistribution of studied HPV subtypes among women with positive HPV was as follows: 49.1% for bothtypes 16 and 18, 10.1% for type 16, 1.69% for type 18 and 22% for type 11 or 6. The prevalence of HPVtype 16 was not significantly different in various cytological categories of cervical neoplasia (P > 0.05).The prevalence of HPV type 16 and 18 was significantly higher than the HPV type 11 or 6 in cervicalneoplastic lesions (P < 0.05).Conclusion : The results of this research indicated the high prevalence of HPV infection in all categoriesof cervical neoplasia. This emphasizes the importance of HPV screening and vaccination programs. In orderto assess more effective screening programs in Isfahan and evaluate the cost-effectiveness of vaccinationprograms, further population-based prospective studies are required.