Human Papilloma Virus Frequency and Genotype Distribution in a Turkish Population

  • Akcali, Sinem (Department of Clinical Microbiology, Faculty of Medicine, Celal Bayar University) ;
  • Goker, Asli (Department of Obstetrics and Gynecology, Faculty of Medicine, Celal Bayar University) ;
  • Ecemis, Talat (Department of Clinical Microbiology, Faculty of Medicine, Celal Bayar University) ;
  • Kandiloglu, Ali Riza (Department of Patholgy, Faculty of Medicine, Celal Bayar University) ;
  • Sanlidag, Tamer (Department of Clinical Microbiology, Faculty of Medicine, Celal Bayar University)
  • Published : 2013.01.31


Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.


  1. Akhan ES (2007). The epidemiology of cervical cancer and HPV serotypes in Turkey. Ankem Dergisi, 21, 96-8.
  2. Altun Z, Yarkin F, Vardar MA, Uguz AH (2011). The prevalence of human papilloma virus infection among women who admitted to cukurova university faculty of medicine hospital. J Med Sci, 31, 307-14.
  3. Bosch FX, Manos MM, Munoz N, et al (1995). The IBSCC study group. Prevalence of human papillomavirus in cervical cancer: a worldwide experience. J Natl Cancer Inst, 87, 796-802.
  4. Casalegno JS, Benchaib M, Le Bail Carval K, et al (2011). Human papillomavirus genotype distribution among French women with and without cervical abnormalities. Int J Gynaecol Obstet, 114, 116-9.
  5. Chinchai T, Chansaenroj J, Junyangdikul P, et al (2011). Comparison between direct sequencing and INNO-LiPA methods for HPV detection and genotyping in Thai Women. Asian Pac J Cancer Prev, 12, 989-94.
  6. Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S (2003). Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer, 88, 63-73.
  7. Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S (2003). Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer, 348, 518-27.
  8. Clifford GM, Smith JS, Aguado T, Franceschi S (2003). Comparison of HPV type distribution in highgrade cervical lesions and cervical cancer: a meta-analysis. Br J Cancer, 89, 101-5.
  9. Crook T, Storey A, Almond N, Osborn K, Crawford L (1988). Human papillomavirus type 16 cooperates with activated ras and fos oncogenes in the hormone-dependent transformation of primary mouse cells. Proc Natl Acad Sci USA, 85, 8820-4.
  10. Cuschieri KS, Cubie HA, Dunne EF, et al (2007). Prevalence of HPV infection among females in the United States. JAMA, 297, 813-9.
  11. Cuschieri KS, Cubie HA, Whitley MW, et al (2004). Multiple high risk HPV infections are common in cervical neoplasia and young women in a cervical screening population. J Clin Pathol, 57, 68-72.
  12. Cuzick J, Szarewski A, Cubie H, et al (2003). Management of women who test is positive for high risk types of Human papillomaviruses. The Hart Study Lancet, 362, 1871-76.
  13. Senol V, Balci E, Cetinkaya F, Elmali F (2012). Women’s knowledge and behavior on cervical cancer, in Kayseri, Turkey. J Med Sci, 32, 694-701.
  14. Solomon D, Davey D, Kurman R, et al (2002). The 2001 bethesda system terminology for reporting results of cervical cytology. JAMA, 16, 2114-9.
  15. Trottier H, Franco EL (2006). The epidemiology of genital human papillomavirus infection. Vaccine, 24, 4-15.
  16. Trottier H, Mahmud S, Costa MC, et al (2006). Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiol Biomarkers Prev, 15, 1274-80.
  17. Vesco KK, Whitlock EP, Eder M, et al (2011). Risk factors and other epidemiologic considerations for cervical cancer screening: a narrative review for the U.S. preventive services task force. Ann Intern Med, 155, 698-705.
  18. Yuce K, Pinar A, Salman MC, et al (2012). Detection and genotyping of cervical HPV with simultaneous cervical cytology in Turkish women: a hospital-based study. Arch Gynecol Obstet, 286, 203-8.
  19. de Sanjose S, Almirall R, Lloveras B, et al (2003). Cervical human papillomavirus infection in the female population in Barcelona, Spain. Sex Transm Dis, 30, 788-93.
  20. de Sanjose S, Diaz M, Castellsague X, et al (2007). Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis, 7, 453-9.
  21. Eroglu C, Kesli R, Eryilmaz MA, et al (2011). Serviks kanseri icin riski olan kadinlarda HPV tiplendirmesi HPV sikliginin risk faktorleri ve servikal smearla iliskisi. Nobel Med, 7, 72-7.
  22. GLOBOCAN (2008). The International Agency for Research on Cancer, WHO, Cancer Incidence and Mortality Worldwide in 2008
  23. IARC Monographs on the Evalution of Carcinogenic Risks to Humans, Volume 90, Human Papilloma Viruses. IARC Pres. Lyon, 2007.
  24. International Collaboration of Epidemiological Studies of Cervical Cancer (2007). Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16573 women with cervical cancer and 35509 women without cervical cancer from 24 epidemiological studies. Lancet, 370, 1609-21.
  25. Khodakarami N, Clifford GM, Yavari P, et al (2012). Human papillomavirus infection in women with and without cervical cancer in Tehran, Iran. Int J Cancer, 131, 156-61.
  26. Munger K, Baldwin A, Edwards KM, et al (2004). Mechanisms of human papillomavirus-induced oncogenesis, J Virol, 78, 11451-60.
  27. Munoz N, Bosch FX, de Sanjose, et al (2003). Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Eng J Med, 348, 518-27.
  28. Parkin DM, Bray F, Ferlay J, Pisani P (2005). Global cancer statistics. CA Cancer J Clin, 55, 74-108.
  29. Piana A, Sotgiu G, Castiglia P, et al (2011). Prevalence and type distribution of human papillomavirus infection in women from North Sardinia, Italy. BMC Public Hlth, 11, 785.
  30. Pista A, de Oliveira CF, Cunha MJ, et al (2011). CLEOPATRE portugal study group. prevalence of human papillomavirus infection in women in Portugal: the CLEOPATRE Portugal study. Int J Gynecol Cancer, 21, 1150-8.
  31. Rock CL, Michael CW, Reynolds RK, Ruffin MT (2000). Prevention of cervical cancer. Crit Rev Oncol Hematol, 33, 169-85.
  32. Sauvaget C, Nene BM, Jayant K, et al (2011). Prevalence and determinants of high-risk human papillomavirus infection in middle-aged Indian women. Sex Transm Dis, 38, 902-6.

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