Journal of Isfahan Medical School

Journal of Isfahan Medical School

Prevalence and Genotype Distribution of Human Papillomavirus in the Female Genital Tract: A Cross-Sectional Study in Kashan, Iran

Document Type : Original Article(s)

Authors
Zahra Vahedpour 1
Mehzad Erami 2
Zahra Hooahyar 1
Reza Nedaeinia 3
Ahmad Piroozmand 4
1 Autoimmune Research Center, Kashan University of Medical Sciences, Kashan, Iran
2 Shahid-Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
3 Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
4 Autoimmune Research Center, Kashan Department of Microbiology and Immunology, Kashan University of Medical Sciences, Kashan, Iran,
10.48305/jims.v44.i869.1164
Abstract
Introduction: Human papillomavirus (HPV) is recognized as the most common sexually transmitted infection worldwide. Given the definitive role of this virus in the pathogenesis of cervical cancer, further studies are necessary to investigate its prevalence at the regional level. The aim of the present study was to investigate the prevalence of genital HPV in women referring to gynecological clinics in Kashan for Pap smear screening in 2017.
Methods: This cross-sectional study was conducted on 292 women referring to specialized obstetrics and gynecology clinics in Kashan for Pap smear screening in 2017. After obtaining informed consent, endocervical and exocervical samples were collected using a spatula and cytobrush for HPV PCR testing. Subsequently, HPV genotypes were determined using the INNO-LiPA HPV Genotyping Extra II method.
Results: The study revealed that among all women referred for Pap smear screening, the HPV test was positive in 25% of cases. The prevalence of high-risk and low-risk genotypes was 41.1% and 58.9%, respectively. Among HPV-positive patients, type 51 was the most frequent (31.5%), followed by type 16 (27.4%).
Conclusion: The present study indicates a high prevalence of HPV among women in Kashan. Furthermore, given the significant prevalence of high-risk genotypes, immunization against HPV should be considered a priority in national vaccination programs.

Highlights

Zahra Vahedpour: Google Scholar, PubMed

Mehzad Erami: Google Scholar

Reza Nedaeinia: Google Scholar, PubMed

Ahmad Piroozmand: Google Scholar, PubMed

Keywords
Human papillomavirus (HPV)
Genotype distribution
Prevalence
Female genital tract
Subjects
1.     de Villiers EM, Fauquet C, Broker TR, Bernard HU, zur Hausen H. Classification of papillomaviruses. Virology 2004; 324(1): 17-27.
2.     Ardekani A, Taherifard E, Mollalo A, Hemadi E, Roshanshad A, Fereidooni R, et al. Human Papillomavirus Infection during Pregnancy and Childhood: A comprehensive review. Microorganisms 2022; 10(10): 1932.
3.     Magalhães GM, Vieira EC, Garcia LC, De Carvalho-Leite MLR, Guedes ACM, Araújo MG. Update on human papilloma virus - part I: epidemiology, pathogenesis, and clinical spectrum. An Bras Dermatol. 2021;96:1–16.
4.     Ghittoni R, Accardi R, Chiocca S, Tommasino M. Role of human papillomaviruses in carcinogenesis. Ecancermedicalscience 2015; 9: 526.
5.     Bakhshani A, Ganjali R, Tabatabaeizadeh SE. Prevalence of Human Papillomavirus (HPV) Genotypes among Women During 2015-2020 in Mashhad, Iran. Arch Iran Med 2023; 26(8): 419-26.
6.     Hildesheim A. Human papillomavirus variants: implications for natural history studies and vaccine development efforts. J Natl Cancer Inst 1997; 89(11): 752-3.
7.     Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348(6): 518-27.
8.     Muñoz N, Bosch FX. Cervical cancer and human papillomavirus: epidemiological evidence and perspectives for prevention. Salud Publica Mex 1997; 39(4): 274-82.
9.     Didelot MN, Boulle N, Damay A, Costes V, Segondy M. Comparison of the PapilloCheck® assay with the digene HC2 HPV DNA assay for the detection of 13 high-risk human papillomaviruses in cervical and anal scrapes. J Med Virol 2011; 83(8): 1377-82.
10.  Khorasanizadeh F, Hassanloo J, Khaksar N, Mohammad Taheri S, Marzaban M, B HR, et al. Epidemiology of cervical cancer and human papilloma virus infection among Iranian women - analyses of national data and systematic review of the literature. Gynecol Oncol 2013; 128(2): 277-81.
11.  Wardak S. Human Papillomavirus (HPV) and cervical cancer. Med Dosw Mikrobiol 2016; 68(1): 73-84.
12.  Lie AK, Risberg B, Borge B, Sandstad B, Delabie J, Rimala R, et al. DNA- versus RNA-based methods for human papillomavirus detection in cervical neoplasia. Gynecol Oncol 2005; 97(3): 908-15.
13.  Schiffman M, Castle PE. The promise of global cervical-cancer prevention. N Engl J Med 2005; 353(20): 2101-4.
14.  Szymonowicz KA, Chen J. Biological and clinical aspects of HPV-related cancers. Cancer Biol Med 2020; 17(4): 864-78.
15.  Yousefzadeh A, Mostafavizadeh SM, Jarollahi A, Raeisi M, Garshasbi M, Siavashvahabi Z, et al. Human papillomavirus (HPV) prevalence and types among women attending regular gynecological visit in Tehran, Iran. Clin Lab 2014; 60(2): 267-73.
16.  Mostafapour Bandpey M, Bostanabad SZ, Rahimi MK. Study of abundance and genotyping of human papillomavirus in samples of patients suspected to cervical cancer referred to masoud laboratory in Tehran [in Persian]. Iran J Med Microbiol 2019; 12(5): 348-56.
17.  Ashrafi GH, Tsirimonaki E, Marchetti B, O'Brien PM, Sibbet GJ, Andrew L, et al. Down-regulation of MHC class I by bovine papillomavirus E5 oncoproteins. Oncogene 2002; 21(2): 248-59.
18.  Hughes FJ, Romanos MA. E1 protein of human papillomavirus is a DNA helicase/ATPase. Nucleic Acids Res 1993; 21(25): 5817-23.
19.  Liu JS, Kuo SR, Broker TR, Chow LT. The functions of human papillomavirus type 11 E1, E2, and E2C proteins in cell-free DNA replication. J Biol Chem 1995; 270(45): 27283-91.
20.  Wang R, Guo XL, Wisman GB, Schuuring E, Wang WF, Zeng ZY, et al. Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China. BMC Infect Dis 2015; 15: 257.
21.  Piras F, Piga M, De Montis A, Zannou AR, Minerba L, Perra MT, et al. Prevalence of human papillomavirus infection in women in Benin, West Africa. Virology 2011; 8: 514.
22.  Clifford GM, Gallus S, Herrero R, Muñoz N, Snijders PJ, Vaccarella S, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 2005; 366(9490): 991-8.
23.  de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol 2010; 11(11): 1048-56.
24.  Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, et al. Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine 2008; 26(Suppl 10): K1-16.
25.  Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, et al. Prevalence of HPV infection among females in the United States. JAMA 2007; 297(8): 813-9.
26.  Hamidi-Fard M, Fattahi-Abdizadeh M, Makvandi M, Ranjbari N, Mansoori E, Samarbaf-Zadeh A. Detection and Genotyping of Human Papillomavirus in Cervical Tissue Samples in Ahvaz, Southwest Iran. Jundishapur J Microbiol 2013; 6(7): e4569.
27.  Ghaffari SR, Sabokbar T, Mollahajian H, Dastan J, Ramezanzadeh F, Ensani F, et al. Prevalence of human papillomavirus genotypes in women with normal and abnormal cervical cytology in Iran. Asian Pac J Cancer Prev 2006; 7(4): 529-32.
28.  Hamkar R, Azad TM, Mahmoodi M, Seyedirashti S, Severini A, Nategh R. Prevalence of human papillomavirus in Mazandaran Province, Islamic Republic of Iran. Eastern Mediterr Health J 2002; 8(6): 805-11.
29.  Piroozmand A, Mostafavi Zadeh SM, Madani A, Soleimani R, Nedaeinia R, Niakan M, et al. The association of high risk human papillomaviruses in patients with cervical cancer: an evidence based study on patients with squamous cell dysplasia or carcinoma for evaluation of 23 human papilloma virus genotypes. Jundishapur J Microbiol 2016; 9(4): e32728.
30.  Mostafavi Zadeh M, Niakan M, Nedaeinia R, Manian M, Avan A, Nedaeinia M, et al. Association of E6 gene expression of high risk human papillomavirus HPV 18 in patients with Cervical squamous cell dysplasia and Cancerous Lesions. Iran J Virol 2015; 9(3): 37-43.
31.  Wolday D, Derese M, Gebressellassie S, Tsegaye B, Ergete W, Gebrehiwot Y, et al. HPV genotype distribution among women with normal and abnormal cervical cytology in a tertiary gynecology referral clinic in Ethiopia. Infect Agents Cancer 2018; 13: 28.
32.  Wang J, Tang D, Wang J, Zhang Z, Chen Y, Wang K, et al. Genotype distribution and prevalence of human papillomavirus among women with cervical cytological abnormalities in Xinjiang, China. Hum Vaccin Immunother 2019; 15(7-8): 1889-96.
33.  Cutts FT, Franceschi S, Goldie S, Castellsague X, de Sanjose S, Garnett G, et al. Human papillomavirus and HPV vaccines: a review. Bull World Health Organ 2007; 85(9): 719-26.
34.  Vu LT, Bui D, Le HT. Prevalence of cervical infection with HPV type 16 and 18 in Vietnam: implications for vaccine campaign. BMC Cancer 2013; 13: 53.
35.  Delgado D, Marín JM, de Diego J, Guerra S, González B, Barrios JL, et al. Human papillomavirus (HPV) genotype distribution in women with abnormal cervical cytology in the Basque Country, Spain. Enferm Infecc Microbiol Clin 2012; 30(5): 230-5.
36.  Niakan M, Yarandi F, Entezar M. Human Papillomavirus (HPV) Detection in Biopsies from Cervical Cancer Patients; A Population–Based Study from Iran. Arch Clin Infect Dis 2009; 4(1): e93397.
37.  Zandi K, Eghbali SS, Hamkar R, Ahmadi S, Ramedani E, Deilami I, et al. Prevalence of various human papillomavirus (HPV) genotypes among women who subjected to routine Pap smear test in Bushehr city (south west of Iran) 2008-2009. Virol J 2010; 7: 65.
38.  Oliveira-Silva M, Lordello CX, Zardo LM, Bonvicino CR, Moreira MA. Human Papillomavirus in Brazilian women with and without cervical lesions. Virol J 2011; 8: 4.
39.  Hwang HS, Park M, Lee SY, Kwon KH, Pang MG. Distribution and prevalence of human papillomavirus genotypes in routine pap smear of 2,470 Korean women determined by DNA chip. Cancer Epidemiol Biomarkers Prev 2004; 13(12): 2153-6.
40.  Smith JS, Melendy A, Rana RK, Pimenta JM. Age-specific prevalence of infection with human papillomavirus in females: a global review. J Adolesc Health 2008; 43(4 Suppl): S5-25, S.e1-41.
 
Journal of Isfahan Medical School
Volume 44, Issue 869
1st Week, September
September and October 2026
Pages 1164-1171

  • Receive Date 03 September 2024
  • Accept Date 18 August 2026