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RESEARCH PRODUCT

Distribution of human papillomavirus types in women from Valencia, Spain, with abnormal cytology.

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Objective To determine human papillomavirus (HPV) types among cervical smears using polymerase chain reaction (PCR) and to contribute to the knowledge of human papillomavirus genotype distribution and prevalence of oncogenic types in cervical lesions in Spain. Study Design Consensus PCR and direct sequencing of PCR products (DNA HPV typing) were used in a retrospective study to determinate the type or types of HPV on 974 cytology smears of women with abnormal cytology results. Results Of 974 smears, 79.8% were high-risk (H-R) HPVs, 19.7% low-risk (L-R) HPVs, 4.6% indeterminate-risk (I-R) HPVs, considering both single and multiple infections. Multiple infections were detected in 4.7% of the cytologies. We detected 40 different HPV types: 17 H-R (HPV26 not detected), 10 L-R (HPVs 40 and HPV 61 not detected) and 13 I-R. The highest percentage of H-R HPV was found in those women with a cytologic high grade squamous intraepithelial lesion (HSIL) (87.4%). HPV 16 was the most frequent genotype. Conclusion There was a significantly higher prevalence rate of H-R HPV in HSIL than in low grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASC-US) (p<0.01). HPV 16 (39.5%) was the most frequent genotype, with a significantly higher prevalence rate of this type in HSIL than in LSIL and ASC-US (p< 0.05 and p < 0.001, respectively). The study of the distribution of HPV and the presence of oncogenic HPV types in our population is important to assess the cost effectiveness of the current vaccines.