Distribution of Human Papilloma Virus Infections of Uterine Cervix among Women of Reproductive Age - a Cross Sectional Hospital-Based Study from North East India

  • Sarma, Usha (Pathology Dept, Gauhati Medical College) ;
  • Mahanta, Jagadish (Regional Medical Research Laboratory for NE (ICMR)) ;
  • Borkakoty, Biswajyoti (Regional Medical Research Laboratory for NE (ICMR)) ;
  • Sarmah, Bidula (Gauhati University)
  • Published : 2015.03.09


Infection of the uterine cervix by human papilloma viruses (HPV) may be associated with cervical pre-cancer and invasive cervical carcinoma if left untreated. With advance in molecular techniques, it has become easier to detect the resence of HPV DNA long before the appearance of any lesion. This study concerned cervical scrape samples of 310 married non-pregnant women attending a gynecology outpatient department for both Pap and PCR testing to detect HPV DNA. Nested PCR using primers for L1 consensus gene with My9/My11 and GP6+/GP5+followed by multiplex PCR were carried out to detect HPV 16 and HPV18. Result: HPV prevalence was 11.9% out of which 3.67% cases of negative for intra-epithelial lesion or malignancy (NILM) and in 71.1% (27/38) of atypical cervical smears were HPV positive. There was increasing trend of high-risk-HPV positivity (HR HPV 16 and 18), from 20% in benign cytology (NILM) to 42.9 % in LSIL, 71.41% in HSIL and 100% in SCC. There was highly significant association of HPV infection with cervical lesion ($x^2=144.0$, p<0.01) and also with type specific HPV prevalence ($x^2=7.761^*$, p<0.05).


Human papilloma virus;cervical cancer;squamous epithelial lesion;PCR;NILM;India


  1. Baay MF, Quint WG, Koudstaal J, et al (1996). Comprehensive study of several general and type-specific primer pairs for detection of human papillomavirus DNA by PCR in paraffinembedded cervical carcinomas. J Clin Microbiol, 34, 745-7.
  2. 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.
  3. Carter JJ, Koutsky LA, Hughes JP et al,.(2000). Comparison of human papillomavirus types 16, 18 and 6 capsid antibody responses following incident infection. J Infect Dis, 181, 1911-9.
  4. Cotton S C, L Sharp, R Seth, et al (2007). Lifestyle and sociodemographic factors associated with high-risk HPV infection in UK women. Br J Cancer, 97, 133-9.
  5. Das B C, Gopalkrishna V, Hedau S and Katiyar S (2000).Cancer of the uterine cervix and human papillomavirus infection. Current Science, 78, 52-63
  6. Das D, Rai AK, Kataki AC, et al (2013). Nested multiplex PCR based detection of human papillomavirus in cervical carcinoma patients of North-East India. Asian Pacific J Cancer Prev, 14, 785-90
  7. Dunne EF, Sternberg M, Lauri E, et al (2011). Human Papillomavirus (HPV) 6, 11, 16 and 18 prevalence among females in the United States-national health and nutrition examination survey, 2003-2006: opportunity to measure hpv vaccine impact? J Infect Dis, 204, 562-5
  8. Argyri E, Papaspyridakos S, Tsimplaki E, et al (2013). A cross sectional study of HPV type prevalence according to age and cytology. BMC Infectious Dis, 13, 53
  9. Evans MF, Adamson CSC, Simmons-Arnold L, Cooper K (2005). Touchdown general primer (GP5+/GP6+) PCR and optimized sample DNA concentration support the sensitive detection of human papillomavirus. BMC Clin Pathol, 5, 10
  10. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  11. Herrington CS (1999). Do HPV-negative cervical carcinomas exist?-revisited. J Pathol, 189, 1-3,<1::AID-PATH432>3.0.CO;2-P
  12. Jemal A, Bray F, Center MM, Ferlay J, Ward E and Forman, D. (2011). Global cancer statistics. CA: A Cancer J Clin, 61, 69-90.
  13. Kailash U, Hedau S, Gopalkrishna V, et al (2002). A simple paper smear method for dry collection, transport and storage of cervical cytological specimens for rapid screening of HPV infection by PCR. J Med Microbiol, 5, 606-10.
  14. Kitchener H C, Almonte M, Wheeler P, et al (2006). HPV testing in routine cervical screening: cross sectional data from the ARTISTIC trial. Br J Cancer, 95, 56-61.
  15. Lin P, Koutsky LA, Critchlow CW, et al (2001). HLA class II DRDQ and increased risk of cervical cancer among Senegalese women. Cancer Epidemiol Biomarkers Prev, 10, 1037-45.
  16. National Cancer registry programme. First report of population based cancer registries under north eastern regional cancer registry 2003-2004. (I.C.M.R.). Retrieved on 3/6/2009.
  17. Park DJ, Wilczynski SP, Paquette RL, Miller CW, Koeffler HP (1994). p53 mutations in HPV-negative cervical carcinoma. Oncogene, 9, 205-10
  18. Rai AK, Das D, Kataki AC, et al (2014). Hybrid capture 2 assay based evaluation of high-risk HPV status in healthy women of north-east India.
  19. Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S (2007). Human papillomavirus and cervical cancer. Lancet, 370, 890-907.
  20. Sharma JD, Kataki AC, Vijay CR (2013). Population-based incidence and patterns of cancer in Kamrup urban cancer registry, India. National Medical L J of India, 26, 133-41
  21. Shukla S, Bharti AC, Mahata S, et al (2010). Application of a multiplex PCR to cervical cells collected by a paper smear for the simultaneous detection of all mucosal human papillomaviruses (HPVs) and typing of high-risk HPV types 16 and 18. J Med Microbiol, 59, 1303-10
  22. Singhal T (2008). Indian academy of pediatrics committee on immunisation (IAPCOI)-consensus recommendations on immunization 2008. Indian Pediatr, 45, 635-48.
  23. Solomon D, Davey D, Kurman R, et al (2002). The 2001 Bethesda system terminology for reporting results of cervical cytology. JAMA, 287, 2114-9
  24. Sotlar K, Diemer D, Dethleffs A, et al (2004). Detection and typing of human papillomavirus by E6 nested multiplex PCR. J Clin Microbiol, 42, 3176-84
  25. Sufang W, Gang Chen, Wang Wei, et al (2005). Value and feasibility of HPV DNA test in cervical scraping smears. J Huazhong Univ Science Technology Medical Science, 25, 451-3
  26. Walboomers JM, Jacobs MV, Manos MM, et al (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol, 189, 12-9<12::AID-PATH431>3.0.CO;2-F
  27. WHO/ICO information centre on HPV and cervical cancer (HPV information centre). Summary report on HPV and cervical cancer statistics in India 2010. Available from:

Cited by

  1. Use of Fast Transfer Analysis Cartridges for Cervical Sampling and Real Time PCR Based High Risk HPV Testing in Cervical Cancer Prevention - a Feasibility Study from South India vol.16, pp.14, 2015,