Prevalence of Human Papillomavirus in Women from Saudi Arabia

  • Turki, Rola (Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Faculty of Medicine) ;
  • Sait, Khalid (Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Faculty of Medicine) ;
  • Anfinan, Nisreen (Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Faculty of Medicine) ;
  • Sohrab, Sayed Sartaj (King Fahd Medical Research Center, King Abdulaziz University) ;
  • Abuzenadah, Adel Mohammed (Faculty of Applied Medical Sciences, Center of Innovation in Personalized Medicine, King Abdulaziz University)
  • Published : 2013.05.30


Background: Human papillomavirus (HPV) infection is the main causes of cervical cancer in women worldwide. The goal of the present study was to determine the prevalence and distribution of HPV genotypes in women from Saudi Arabia. Recently, several HPV detection methods have been developed, each with different sensitivities and specificities. Methods: In this study, total forty cervical samples were subjected to polymerase chain reaction and hybridization to BioFilmChip microarray assessment. Results: Human papillomavirus (HPV) infections were found in 43% of the specimens. The most prevalent genotypes were HPV 16 (30%) HPV 18 (8.0%) followed by type HPV 45, occurring at 5.0%. Conclusion: Our finding showed the HPV infection and prevalence is increasing at alarming rate in women of Saudi Arabia. There was no low risk infection detected in the tested samples. The BioFilmChip microarray detection system is highly accurate and suitable for detection of single and multiple infections, allowing rapid detection with less time-consumption and easier performance as compared with other methods.


  1. Bao YP, Li N, Smith JS, et al (2008). Human papillomavirus type distribution in women from Asia: a meta-analysis. Int J Gynecol Cancer, 18, 71-9.
  2. Bosch FX, Manos MM, Munoz N, et al (1995). Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) study group. J Natl Cancer Inst, 87, 796-802.
  3. Bouvard V, Baan R, Straif K, et al (2009). A review of human carcinogens--Part B: biological agents. Lancet Oncol, 10, 321-2.
  4. Bruni L, Diaz M, Castellsague X, et al (2010). Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis, 202, 1789-99.
  5. Chansaenroj J, Lurchachaiwong W, Termrungruanglert W, et al (2010). Prevalence and genotypes of human papillomavirus among Thai women. Asian Pac J Cancer Prev, 11, 117-22.
  6. Chen HC, Schiffman M, Lin CY, et al (2011). Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer. J Natl Cancer Inst, 103, 1387-96.
  7. Chen Q, Xie LX, Qing ZR, et al (2012). Epidemiologic characterization of human papillomavirus infection in rural chaozhou, eastern guangdong province of china. PLoS One, 7, 32149.
  8. Chen Q, Zhao Y L, Min L et al (2012). Prevalence and Genotype Distribution of Human Papillomavirus Infections in Women Attending Hospitals in Chaozhou of Guangdong Province. Asian Pacific J Cancer Prevention, 13, 1519-24.
  9. Chumworathayi B, Thinkhamrop J, Blumenthal PD, et al (2010). Cryotherapy for HPV clearance in women with biopsyconfirmed cervical low-grade squamous intraepithelial lesions. Int J Gynaecol Obstet, 108, 119-22.
  10. Clifford GM, Gallus S, Herrero R, et al (2005). 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, 366, 991-8.
  11. Clifford GM, Rana RK, Franceschi S, et al (2005). Human papillomavirus genotype distribution in low-grade cervical lesions: comparison by geographic region and with cervical cancer. Cancer Epidemiol Biomarkers Prev, 14, 1157-64.
  12. Cuzick J, Sasieni P, Davies P, et al (2000). A systematic review of the role of human papillomavirus (HPV) testing within a cervical screening programme: summary and conclusions. Br J Cancer, 83, 561-65.
  13. 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.
  14. Galan-Sanchez F, Rodriguez-Iglesias MA (2009). Comparison of human papillomavirus genotyping using commercial assays based on PCR and reverse hybridization methods. APMIS, 117, 708-15.
  15. Harper DM, Franco EL, Wheeler C, et al (2004). Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet, 364, 1757-65.
  16. Hildesheim A, Schiffman MH, Gravitt P, et al (1994). Persistence of type specific human papillomavirus infection among cytologically normal women. J Infect Dis, 169, 235-240.
  17. Hwang HS, Park M, Lee SY, et al (2004). Distribution and prevalence of human papillomavirus genotypes in routine pap smear of 2.470 Korean women determined by DNA chip. Cancer Epidemiol Biomarkers Prev, 13, 2153-6.
  18. Jacobs M, Snijders P, Voorhorst F, et al (1999). Reliable high risk HPV DNA testing by polymerase chain reaction: an inter method and intra method comparison. J Clin Pathol, 52, 498-503.
  19. Lazcano Ponce E, Herrero R, Munoz N, et al (2001). Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer, 91, 412-20.<412::AID-IJC1071>3.0.CO;2-M
  20. Ley C, Bauer H, Reingold A, et al (1991). Determinants of genital human papillomavirus infection in young women. J Natl Cancer Inst, 83, 997-1003.
  21. Liaw KL, Hsing AW, Chen CJ, et al (1995). Human papillomavirus and cervical neoplasia: a case control study in Taiwan. Int J Cancer, 62, 565-71.
  22. Lie AK, Kristensen G (2008). Human papillomavirus E6/E7 mRNA testing as a predictive marker for cervical carcinoma. Rev Mol Diag, 8, 405-415.
  23. Lin M, Yang LY, Li LJ, et al (2008). Genital human papillomavirus screening by gene chip in Chinese women of Guangdong province. Aust N Z J Obstet Gynaecol, 48, 189-94.
  24. Matsumoto K (2007). Human papillomavirus and cervical cancer. Nipon Rinsho, 65, 2113-124.
  25. Meijer CJ, Snijders PJ, Castle PE (2006). Clinical utility of HPV genotyping. Gynecol Oncol, 103, 12-17.
  26. Middleton K, Peh W, Southern S, et al (2003). Organization of human papillomavirus productive cycle during neoplastic progression provides a basis for selection of diagnostic markers. J Virol, 77, 10186-201.
  27. Miura S, Matsumoto K, Oki A, et al (2006). Do we need a different strategy for HPV screening and vaccination in East Asia? Int J Cancer, 119, 2713-5.
  28. Moscicki AB, Schiffman M, Kjaer S et al (2006). Updating the natural history of HPV and anogenital cancer. Chapter 5. Vaccine, 24, 42-51.
  29. Munoz N, Bosch FX, de San Jose S, et al (2003). Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med, 348, 518-27.
  30. Munoz N, Castellsague X, de Gonzalez AB et al (2006). HPV in the etiology of human cancer. Chapter 1. Vaccine, 24, 1-10.
  31. Parkin DM, Bray F (2006). The burden of HPV related cancers. Vaccine, 24, 11-25.
  32. Peto J, Gilham C, Deacon J, et al (2004). Cervical HPV infection and neoplasia in a large population-based prospective study: the Manchester cohort. Br J Cancer, 91, 942-53.
  33. Raffle AE, Alden B, Mackenzie EF (1995). Detection rates for abnormal cervical smear: what are we screening for? Lancet, 345, 1469-73.
  34. Rousseau MC, Villa LL, Costa MC, et al (2003). Occurrence of cervical infection with multiple human papillomavirus types is associated with age and cytologic abnormalities. Sex Transm Dis, 30, 581-7.
  35. Shadrina MI, Semenova EV, Slominsky PA, et al (2007). Effective quantitative real-time polymerase chain reaction analysis of the parkin gene (PARK2) exon 1-12 dosage. BMC Med Genet, 26, 8-6.
  36. Shafi MI (1994). Management of women with mild dyskaryosis. Cytological surveillance avoids treatment. Br Med J, 309, 590-1.
  37. Sun ZR, Ji YH, Zhou WQ, et al (2010). Characteristics of HPV prevalence among women in Liaoning province, China. Int J Gynaecol Obstet, 109, 105-9.
  38. Szostek S, Klimek M, Zawilinska B et al (2008). Genotype specific human papillomavirus detection in cervical smears. A Bioch Polonica, 55, 687-92.
  39. Thomas JO, Herrero R, Omigbodun AA, et al (2004). Prevalence of Papillomavirus in women in Idaban, Nigeria: a population based study. Br J Cancer, 90, 638-45.
  40. Trottier H, Burchell AN (2009). Epidemiology of mucosal human papillomavirus infection and associated diseases. Public Health Genomics, 12, 291-307.
  41. 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.
  42. Tucker RA, Johnson PR, Reeves WC, et al (1993). Using the polymerase chain reaction to genotype human papillomavirus DNAs in samples containing multiple HPVs may produce inaccurate results. J Virol Methods, 43, 321-33.
  43. Villa LL, Costa RL, Petta CA, et al (2005). Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol, 6, 271-8.
  44. Walboomers JM, Jacobs MV, Manos MM, et al (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol, 189, 12-19.<12::AID-PATH431>3.0.CO;2-F
  45. Wheeler CM, Parmenter CA, Hunt WC, et al (1993). Determinants of genital human papillomavirus infection among cytologically normal women attending the University of New Mexico Student Health Center. Sex Transm Dis, 20, 286-89.
  46. Woodman CB, Collins SI, Young LS (2007). The natural history of cervical HPV infection: unresolved issues. Nat Rev Cancer, 7, 11-22.
  47. Yoshikawa H (2009). Progress and challenges on HPV vaccination. Uirusu, 59, 243-8.
  48. Young L, Bevan I, Johnson M, et al (1989). The polymerase chain reaction. Br Med J, 298, 14-18.

Cited by

  1. Assessing Oral Cancer Knowledge Among Saudi Medical Undergraduates vol.28, pp.4, 2013,
  2. Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia vol.14, pp.1, 2014,
  3. Awareness of Risk Factors for Cancer among Omani adults- A Community Based Study vol.15, pp.13, 2014,
  4. Development of In-House Multiplex Real Time PCR for Human Papillomavirus Genotyping in Iranian Women with Cervical Cancer and Cervical Intraepithelial Neoplasia vol.15, pp.15, 2014,
  5. C13orf18 and C1orf166 (MULAN) DNA Genes Methylation are Not Associated with Cervical Cancer and Precancerous Lesions of Human Papillomavirus Genotypes in Iranian Women vol.15, pp.16, 2014,
  6. Human Papillomavirus Genotype Distribution and E6/E7 Oncogene Expression in Turkish Women with Cervical Cytological Findings vol.15, pp.9, 2014,