TITLE:
Distribution of High-Risk Human Papillomavirus Genotypes among Women with Colposcopic Diagnosis of Cervical Intraepithelial Neoplasia in Bangladesh
AUTHORS:
Siddika Mosammat Shahida, Mina Chowdhury, Fatima Shajahan, Jannat Ara Rifat, Alfi Sharin Lubaba, S. M. Shamsuzzaman, Annekathryn Goodman
KEYWORDS:
Bangladesh, Cervical Cancer, Cervical Intraepithelial Neoplasia, Human Papillomavirus Infection, High-Risk HPV
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.14 No.6,
June
19,
2023
ABSTRACT: Background: The incidence of cervical cancer is high in Bangladesh and there is a
high prevalence of preinvasive lower genital tract disease among women of
reproductive age. Persistent high-risk Human Papilloma Virus (HPV) infection is
the main underlying cause of cervical cancer and its precursor, cervical
intraepithelial neoplasia (CIN). Objective: The aim of the study was to
identify the subtypes of high-risk HPV infection among women with the
colposcopic diagnosis of cervical intraepithelial neoplasia in Bangladesh. Methods: This cross-sectional observational study was conducted in the colposcopy
clinic of Dhaka Medical College Hospital over a six-month period. A total of
100 participants were enrolled. Married women, between 30 - 60 years
of age with colposcopically diagnosed cervical intra epithelial neoplasia were
enrolled. Women with chronic illness, pregnancy, and women unable to consent
were excluded from this study. After counselling, colposcopically directed
punch biopsies were taken from each CIN case concurrently with high-risk HPV
testing by polymerase chain reaction (PCR). Results: The mean age of the patients was 38.69 (SD ±7.76)
years. CIN 1 was diagnosed in 57% of participants, while 24% had CIN II and 19%
had CIN III lesions. High-risk HPV was present in 52 patients. HPV 16 was the
most common identified in 28 (53.84%) and HPV 18 was the second most common
with 20 (38.46%) either singly or in combination with other high-risk subtypes.
The other HPV strains, HPV 31, 33, 35, 52, 56 and 58, were also detected either
as mono or co-infections. Out of the 52 HPV positive cases, 29 (55.8%) had mono
infection and 23 (44.2%) had co-infection with several subtypes. The highest
incidence (50%) of oncogenic HPV infections was present among women aged 35 - 45 years.
Risk factors associated with HPV positive cases were high parity (P 0.05),
early age at marriage (P = 0.754) and early age of first child. Conclusion: This study identified a high prevalence of HPV 16 and 18 genotypes. HPV
vaccination with the current 9-valent HPV vaccine, which contains HPV types 6,
11, 16, 18, 31, 33, 45, 52, and 58. Will be an effective public health measure
to eradicate cervical cancer in Bangladesh.