Research Article: Unusual prevalence of high-risk genotypes of human papillomavirus in a group of women with neoplastic lesions and cervical cancer from Central Mexico

Date Published: April 18, 2019

Publisher: Public Library of Science

Author(s): Rafael Gutiérrez Campos, Angélica Malacara Rosas, Elvia Gutiérrez Santillán, Mireya Delgado Gutiérrez, Rusland Enrique Torres Orozco, Elí Daniel García Martínez, Luis Fernando Torres Bernal, Alejandro Rosas Cabral, Magdalena Grce.


Human papillomavirus has been identified as a main etiological agent in the development of cervical cancer. HPV 16 and 18 have been reported the most widely prevalent genotypes worldwide. We conducted a study analyzing the prevalence of high and low risk human papillomavirus viral types in the Mexican state of Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in central Mexico. Specific viral genotype was determined by a PCR and hybridization-based detection test. The presence of 37 high- and low-risk HPV genotypes was evaluated in 883 female participants. Of these, 350 presented low-grade squamous intraepithelial lesions (LGSIL), 176 presented high-grade squamous intraepithelial lesions (HGSIL), 107 suffered from cervical cancer and 250 women with negative cytological report for intraepithelial lesion or malignancy (NILM). HPV 51 was the most prevalent genotype, followed by HPV 16: overall prevalence of HPV 51, including single infections and co-infections was 31.2% in women with LGSIL, whereas prevalence of HPV 16 was 25.1%. Among women with HGSIL, HPV 51 prevalence was 47.2% and HPV 16 was 30.1%. Prevalence of HPV 51 in women with cervical cancer was 49.5% and type 16 was 33.6%. Between single and co-infections, most co-infections were not associated with later stages of the disease, except 51/16 and some others. HPV 51 showed a significant correlation with the progression of the disease (OR = 10.81 for LGSIL, 19.38 for HGSIL and 22.95 for ICC), and when analyzing all other genotypes, five different groups depending on their correlation with all lesion grades were determined. According to our findings, HPV genotype 51 has a higher prevalence than HPV 16 and 18 in the Mexican state of Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in Central Mexico.

Partial Text

Cervical cancer is the fourth leading cause of death by cancer in women worldwide. An estimated 500,000 new cases occur annually worldwide, and approximately 270,000 women die due to this illness each year [1]. Most of these cases occur in Latin America [2] and the Caribbean, as well as in Africa [3] and Asia [4]. Mexico has the second place in cervical cancer only below the African continent [5].

A total of 883 samples of women aged between 15 and 71 years were analyzed. All samples were obtained from Hospital General de Zona Número 1 of the Instituto Mexicano del Seguro Social of Aguascalientes city. This Health facility receives patients of Aguascalientes and the neighboring states of Jalisco and Zacatecas (central México). 248 samples were obtained from women without a cytological report for intraepithelial neoplasia or malignancy (NILM), 349 samples corresponded to low-grade squamous intraepithelial lesions (LSIL), 176 samples to high-grade intraepithelial lesions, and 110 samples were shown to have cervical cancer (CC).

Cervical cancer is the second most frequent form of cancer in Mexico, with a standardized mortality rate between 2006 and 2010 of 9.2 deaths per 100,000 women, thus representing the second leading cause of death in Mexican women. Although a decrease on the frequency of cervical cancer has been reported in recent years, mainly because of the implementation of cytology-based detection programs since 1941, this strategy has not translated into a net reduction of mortality, kept excessively high and above the standardized rate per age group reported worldwide as 7.1 per 100,000 for this neoplasia [18].

We found an elevated prevalence of infection by HPV 51, a high rate of co-infections between HPV 51 and 16 and a differential association between the risks of progression of the disease from the asymptomatic infection until the development of cervical cancer among the different high-risk HPV genotypes.




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