DOI QR코드

DOI QR Code

Detection of Genital HPV Infection Using Urine Samples: a Population Based Study in India

  • Published : 2016.04.11

Abstract

Background: Cervical cancer is the second commonest cancer among Indian women and its association with human papilloma virus (HPV) is well established. This preventable cancer accounts for the maximum number of cancer related deaths among rural Indian women. Unlike in developed countries there are no organized cervical cancer screening programmes in India due to lack of resources and manpower. Objective: To detect genital HPV infection using urine samples among asymptomatic rural women in the age group of 18-65 years. Materials and Methods: The study area chosen was Perdoor village in Udupi Taluk, Karnataka State and all the women in the age group of 18-65 years formed the study cohort. A cross sectional study was conducted by house visits and 1,305 women were enrolled in the study. After taking written informed consent a data sheet was filled and early stream random urine samples were collected, transported to a laboratory at 4OC and aliquoted. Samples were tested using nested HPV PCR with PGMY09/11 and GP5+/6+ primers. Positive cases were genotyped by sequence analysis. Results: Study participants included 1,134 sexually active and 171 unmarried women with a mean age at marriage of 22.1 (SD=3.9) years. Study area showed high female literacy rate of 86.6%. Five urine samples tested positive for HPV DNA (0.4%). Conclusions: We found very low genital HPV infection rate among women from monogamous community. This is the first major population based study carried out among asymptomatic rural women to detect genital HPV infectio from Karnataka using urine samples.

Keywords

References

  1. Aggarwal P (2014). Cervical cancer: Can it be prevented? World J Clin Oncol, 5, 775-80. https://doi.org/10.5306/wjco.v5.i4.775
  2. Albero G, Castellsague X, Giuliano AR, et al (2012). Male circumcision and genital human papillomavirus: a systematic review and meta-analysis. Sex Transm Dis, 39, 104-13. https://doi.org/10.1097/OLQ.0b013e3182387abd
  3. Asiaf A, Ahmad ST, Zargar MA, et al (2012). Prevalence of human papillomavirus infection in a Kashmiri ethnic female population. Genet Test Mol Biomarkers, 16, 904-9. https://doi.org/10.1089/gtmb.2011.0354
  4. Bhatla N, Lal N, Bao YP, et al (2008). A meta-analysis of human papillomavirus type-distribution in women from South Asia: implications for vaccination. Vaccine, 26, 2811-7. https://doi.org/10.1016/j.vaccine.2008.03.047
  5. 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. https://doi.org/10.1086/657321
  6. D'Souza G BR, Zhong Y, Minkoff H, Massad LS, Xue X, et al. (2012). Cervicovaginal HPV infection before and after hysterectomy: evidence of different tissue tropism for oncogenic and non-oncogenic HPV types in a cohort of HIV-positive and HIV-negative women. Int J Cancer J Int Cancer, 131, 1472-8. . https://doi.org/10.1002/ijc.27363
  7. Das B.C SJK, Gopalkrishna. V, Das D.K, Singh V, Gissmann L, et al (1992). A high frequency of human papillomavirus DNA sequences in cervical carcinomas of Indian women as revealed by southern blot hybridization and polymerase chain reaction. J Med Virol, 36, 239-45. https://doi.org/10.1002/jmv.1890360402
  8. Eghbali SS, Amirinejad R, Obeidi N, et al (2012). Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data. Virol J, 9, 194. https://doi.org/10.1186/1743-422X-9-194
  9. Enerly E, Olofsson C, Nygard M (2013). Monitoring human papillomavirus prevalence in urine samples: a review. Clin Epidemiol, 5, 67-79.
  10. Franceschi S, Rajkumar R, Snijders PJ, et al (2005). Papillomavirus infection in rural women in southern India. Br J Cancer, 92, 601-6. https://doi.org/10.1038/sj.bjc.6602348
  11. Giorgi Rossi P, Bisanzi S, Paganini I, et al (2010). Prevalence of HPV high and low risk types in cervical samples from the Italian general population: a population based study. BMC Infect Dis, 10, 214. https://doi.org/10.1186/1471-2334-10-214
  12. Gouws E, Mishra V, Fowler TB (2008). Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data. Sex Transm Infect, 84, 17-23. https://doi.org/10.1136/sti.2007.026815
  13. Gravitt PE, Peyton CL, Alessi TQ, et al (2000). Improved amplification of genital human papillomaviruses. J Clin Microbiol, 38, 357-61.
  14. Jalilvand S, Shoja Z, Nourijelyani K, et al (2015). Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer: Implications for screening and vaccination. J Med Virol, 87, 287-95. https://doi.org/10.1002/jmv.24053
  15. Kabekkodu SP, Bhat S, Pandey D, et al (2015). Prevalence of human papillomavirus types and phylogenetic analysis of HPV-16 L1 variants from Southern India. Asian Pac J Cancer Prev, 16, 2073-80. https://doi.org/10.7314/APJCP.2015.16.5.2073
  16. Koliopoulos G, Arbyn M, Martin-Hirsch P, et al (2007). Diagnostic accuracy of human papillomavirus testing in primary cervical screening: a systematic review and meta-analysis of non-randomized studies. Gynecol Oncol, 104, 232-46. https://doi.org/10.1016/j.ygyno.2006.08.053
  17. Kulkarni SS, Kulkarni SS, Vastrad PP, et al (2011). Prevalence and distribution of high risk human papillomavirus (HPV) Types 16 and 18 in Carcinoma of cervix, saliva of patients with oral squamous cell carcinoma and in the general population in Karnataka, India. Asian Pac J Cancer Prev, 12, 645-8.
  18. Mendez K, Romaguera J, Ortiz AP, et al (2014). Urine-based human papillomavirus DNA testing as a screening tool for cervical cancer in high-risk women. Int J Gynaecol Obstet, 124, 151-5. https://doi.org/10.1016/j.ijgo.2013.07.036
  19. Mollers M, Boot HJ, Vriend HJ, et al (2013). Prevalence, incidence and persistence of genital HPV infections in a large cohort of sexually active young women in the Netherlands. Vaccine, 31, 394-401. https://doi.org/10.1016/j.vaccine.2012.10.087
  20. Moscicki AB, Schiffman M, Burchell A, et al (2012). Updating the natural history of human papillomavirus and anogenital cancers. Vaccine, 30, 24-33.
  21. Nahar Q, Sultana F, Alam A, et al (2014). Genital human papillomavirus infection among women in Bangladesh: findings from a population-based survey. PLoS One, 9, 107675. https://doi.org/10.1371/journal.pone.0107675
  22. Nair NS, Rao RS, Chandrashekar S, et al (2000). Socio-demographic and maternal determinants of low birth weight: a multivariate approach. Indian J Pediatr, 67, 9-14. https://doi.org/10.1007/BF02802625
  23. Nigam A, Saxena P, Acharya AS, et al (2014). HPV vaccination in India: critical appraisal. ISRN Obstet Gynecol, 2014, 394595.
  24. O'Leary MC, Sinka K, Robertson C, et al (2011). HPV type-specific prevalence using a urine assay in unvaccinated male and female 11- to 18-year olds in Scotland. Br J Cancer, 104, 1221-6. https://doi.org/10.1038/bjc.2011.30
  25. Parvez R, Hedau S, Bhattacharya D, et al (2012). High-risk HPV infection among the tribal and non-tribal women of the andaman and nicobar islands, India. Public Health, 126, 67-9. https://doi.org/10.1016/j.puhe.2011.09.018
  26. Pathak N, Dodds J, Zamora J, et al (2014). Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis. BMJ, 349, 5264. https://doi.org/10.1136/bmj.g5264
  27. Prusty BK, Kumar A, Arora R, et al (2005). Human papillomavirus (HPV) DNA detection in self-collected urine. Int J Gynaecol Obstet, 90, 223-7. https://doi.org/10.1016/j.ijgo.2005.06.004
  28. R. dRA-Md (1995). The use of general primers GP5+/GP6+elongated at their 3' ends with adjacent highly conserved sequences improves human papilloma virus detection by PCR. J Gen Virol, 76, 1057-62. https://doi.org/10.1099/0022-1317-76-4-1057
  29. Sabeena S, Bhat PV, Kamath V, et al (2015). Knowledge, attitude and practice concerning human papilloma virus infection and its health effects among rural women, Karnataka, South India. Asian Pac J Cancer Prev, 16, 5053-8. https://doi.org/10.7314/APJCP.2015.16.12.5053
  30. Sankaranarayanan R, Nene BM, Dinshaw KA, et al (2005). A cluster randomized controlled trial of visual, cytology and human papillomavirus screening for cancer of the cervix in rural India. Int J Cancer, 116, 617-23. https://doi.org/10.1002/ijc.21050
  31. 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. https://doi.org/10.1097/OLQ.0b013e318223be5f
  32. Senapathy JG, Umadevi P, Kannika PS (2011). The present scenario of cervical cancer control and HPV epidemiology in India: an outline. Asian Pac J Cancer Prev, 12, 1107-15.
  33. Sharma K, Kathait A, Jain A, et al (2015). Higher prevalence of human papillomavirus infection in adolescent and young adult girls belonging to different Indian tribes with varied socio-sexual lifestyle. PLoS One, 10, 125693.
  34. Srivastava S, Gupta S, Roy JK (2012). High prevalence of oncogenic HPV-16 in cervical smears of asymptomatic women of eastern Uttar Pradesh, India: a population-based study. J Biosci, 37, 63-72. https://doi.org/10.1007/s12038-012-9181-y
  35. Sureshkumar BT, Shanmughapriya S, Das BC, et al (2015). A population-based study of the prevalence of HPV in three districts of Tamil Nadu, India. Int J Gynaecol Obstet, 129, 58-61. https://doi.org/10.1016/j.ijgo.2014.10.025
  36. Tanzi E, Bianchi S, Fasolo MM, et al (2013). High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping. J Med Virol, 85, 91-8. https://doi.org/10.1002/jmv.23434
  37. Trottier H, Ferreira S, Thomann P, et al (2010). Human papillomavirus infection and reinfection in adult women: the role of sexual activity and natural immunity. Cancer Res, 70, 8569-77. https://doi.org/10.1158/0008-5472.CAN-10-0621
  38. Veldhuijzen NJ, Snijders PJ, Reiss P, et al (2010). Factors affecting transmission of mucosal human papillomavirus. Lancet Infect Dis, 10, 862-74. https://doi.org/10.1016/S1473-3099(10)70190-0
  39. Vorsters A, Micalessi I, Bilcke J, et al (2012). Detection of human papillomavirus DNA in urine. A review of the literature. Eur J Clin Microbiol Infect Dis, 31, 627-40. https://doi.org/10.1007/s10096-011-1358-z
  40. Vorsters A, Van den Bergh J, Micalessi I, et al (2014). Optimization of HPV DNA detection in urine by improving collection, storage, and extraction. Eur J Clin Microbiol Infect Dis, 33, 2005-14. https://doi.org/10.1007/s10096-014-2147-2
  41. 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. https://doi.org/10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
  42. Yang L, Yang H, Wu K, et al (2014). Prevalence of HPV and variation of HPV 16/HPV 18 E6/E7 genes in cervical cancer in women in South West China. J Med Virol, 86, 1926-36. https://doi.org/10.1002/jmv.24043

Cited by

  1. Possible non-sexual modes of transmission of human papilloma virus vol.43, pp.3, 2017, https://doi.org/10.1111/jog.13248