Nagaraja Mudhigeti, Narendra Hulikal, Venkataramana Banda, Kalawat Usha
Department of Clinical Virology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507, Andhra Pradesh, India.
Department of Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517 507, Andhra Pradesh, India.
Indian J Med Microbiol. 2023 May-Jun;43:73-78. doi: 10.1016/j.ijmmb.2022.09.004. Epub 2022 Oct 11.
Human papillomavirus (HPV) causes genital and oropharyngeal cancers worldwide. There are significant gaps exist in the data on HPV genotype prevalence in this part of the country. HPV vaccination is one of the best preventive methods available currently. HPV genotyping plays an important role in the selection of appropriate vaccines and monitoring vaccine efficacy and coverage. The present study aimed to determine the HPV genotype prevalence and to estimate the potential impact of HPV vaccines on invasive cervical cancer.
A total of 204 cervical biopsy samples collected from symptomatic women were subjected to an in-house designed and standardised nested multiplex PCR (NM-PCR) assay. The NM-PCR was designed to detect 38 Mucosal HPV types as a pooled result and genotyping of 15 HPV types. Further, the HPV genotype data was used to estimate the HPV vaccine bivalent, quadrivalent and nonavalent impact on the population using a mathematical formula.
Out of 204 samples 188 were subjected to HPV-nested PCR. A total of 163 (86.7%) samples were positive for at least one HPV type. Multiple genotypes were identified in 30% of samples processed. HPV-16 (85.3%) was the most frequently detected genotype followed by HPV-18 (13.5%) and HPV-33 (11.0%). Other genotypes were observed less frequently. Based on the HPV prevalence observed in the study a mathematical model estimated the efficacy of bivalent, quadrivalent and nonavalent vaccines were 76.1%, 76.7%, and 91.1% (average) respectively.
HPV-16 was the most prevalent (>85%) genotype detected in this study. Multiple infections observed in 30% of samples were quite high as compared to the majority of national, and global reference (15-25.4%) data. The Mathematical model showed that a nonavalent vaccine would give better protection.
人乳头瘤病毒（HPV）在全球范围内引发生殖器癌和口咽癌。该国这一地区HPV基因型流行情况的数据存在显著空白。HPV疫苗接种是目前可用的最佳预防方法之一。HPV基因分型在选择合适疫苗以及监测疫苗效力和覆盖率方面发挥着重要作用。本研究旨在确定HPV基因型流行情况，并评估HPV疫苗对浸润性宫颈癌的潜在影响。
从有症状的女性中收集了204份宫颈活检样本，进行内部设计并标准化的巢式多重PCR（NM-PCR）检测。NM-PCR旨在作为汇总结果检测38种黏膜HPV类型，并对15种HPV类型进行基因分型。此外，使用数学公式，将HPV基因型数据用于评估二价、四价和九价HPV疫苗对人群的影响。
在204份样本中，188份进行了HPV巢式PCR检测。共有163份（86.7%）样本至少对一种HPV类型呈阳性。在30%的检测样本中鉴定出多种基因型。HPV-16（85.3%）是最常检测到的基因型，其次是HPV-18（13.5%）和HPV-33（11.0%）。其他基因型的检出频率较低。根据研究中观察到的HPV流行情况，一个数学模型估计二价、四价和九价疫苗的效力分别为76.1%、76.7%和91.1%（平均）。
HPV-16是本研究中检测到的最常见（>85%）基因型。与大多数国家和全球参考数据（15 - 25.4%）相比，30%的样本中观察到的多重感染率相当高。数学模型表明，九价疫苗能提供更好的保护。
