Relation of HPV genotyping by PCR to cervical Pap smear results in women with genital warts


ABSTRACT: Background Papillomavirus is genera of the family Papovaviridae. The papilloma virus yield in their host benign skin tumors. The greatest common genital lesion produced by HPV infection is the benign genital wart (condylomata acuminata). Types HPV-6 and -11 are the main types associated with these lesions. This wart is distributed throughout the female genital tract on the cervix, vaginal wall, and vulva and perianal region. The importance of genital warts is its relation to the risk factors of cervical carcinoma, so perfect genotyping is essential in the management of these patients. In addition, the finding of premalignant lesions of the cervix is also essential in the management and this can be done easily by cervical pap smears. Aim: HPV genotype in patients with genital warts by PCR technique and the identification of the relation of genital warts with pap smear results in women from Nineveh Governorate. Materials and methods: the current study a cross sectional was performed over 12 months period from June 2013 through June 2014, with a total of 551 cervical/Pap smears test were collected of women seeking gynecological advice for different complaints attending the major three hospitals in Mosul city, the ages between 11 and 76 years, with a mean age of 38.4 years. Chi-square test of independence; were designed for two catigoral variables. P-values ≤ 0.05 were taken into account statistically significant all over data analysis. The other part of the work including the HPV DNA tests which were applied by the PCR technique (by HPV Direct Flow Chip for in vitro detection, Master Diagnostica Kit, is aimed at simultaneous screening and genotyping of 36 HPV genotypes, High risk-HPV and low risk-HPV by PCR, after that reverse dot blot automatic hybridization, based on DNA-Flow Technology (e-BRID System) Results: The cervical pap smears results of the women were classified according to Bethesda system into two groups. The largest No. of the results was negative intraepithelial or malignancy (NILM), 452/551 (82.03%), while the cervical epithelial abnormalities (EA) in the other group was 99/551(17.97%) women. The highest rate of cases with cervical EA cytological results was found in women with non genital warts (93.94%). The rate of cervical EA in women with genital warts compared to no warts, were 6.06%. The infection of HPV was representing 17.96% same as the percentage of cervical EA results. There were three categories of genotypes for HPV in cervical EA: low risk-HPV, high risk-HPV, and mixed infection (low and high risk-HPV). All cases had history of genital warts in the present study were positive for HPV100% (6/6). Different HPV genotypes found in the present study, five distinct HPV genotypes were detected in genital warts which were HPV-6, 11, 16, 18, 31. The predominant type in genital warts to HPV-18 3/6. Conclusion: From present results it can be concluded that; 1- the rate of HPV infection in Nineveh women suffering from genital warts were 6/6 (100%). 2- the most predominant HPV genotypes commonly related with genital warts were the high risk HPV predominantly genotype HPV-18. 3- the relation between genital warts with pap smear results were non- significant p=0.5.