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. 2022 Jan-Dec:29:10732748221103331.
doi: 10.1177/10732748221103331.

Prevalence and Distribution of Human Papillomavirus Genotypes (1997-2019) and Their Association With Cervical Cancer and Precursor Lesions in Women From Southern Mexico

Luz Del Carmen Alarcón-Romero  1 , Jorge Organista-Nava  2 , Yazmín Gómez-Gómez  2 , Julio Ortiz-Ortiz  2 , Daniel Hernández-Sotelo  3 , Oscar Del Moral-Hernández  4 , Miguel Angel Mendoza-Catalán  2 , Ramón Antaño-Arias  2 , Marco Antonio Leyva-Vázquez  2 , Natividad Sales-Linares  2 , Verónica Antonio-Véjar  2 , Berenice Illades-Aguiar  2
Affiliations

Prevalence and Distribution of Human Papillomavirus Genotypes (1997-2019) and Their Association With Cervical Cancer and Precursor Lesions in Women From Southern Mexico

Luz Del Carmen Alarcón-Romero et al. Cancer Control. 2022 Jan-Dec.

Abstract

Background: Cervical cancer (CC) is the fourth most common malignancy of the female genital tract. Human Papillomavirus (HPV) is the main cause of precancerous lesions and CC cases worldwide.

Objective: We assessed the prevalence and distribution of HPV types and their association with precancerous lesions and CC.

Methods: HPV genotypes were detected by 3 methods depending on the year of in which the sample was analyzed: MY09/11 RFLPs (1997 to 2010), GP5+/6+ primer systems (2005 to 2010) and INNO-LiPA HPV Genotyping Extra (2010 to 2019) in cervical samples (No-IL: 4445; LSIL: 2464; HSILs: 151 and CC: 253) from women from southern Mexico.

Results: The overall HPV prevalence was 54.17%, and hpv-16 was the most common genotype. In single infection, the high-risk HPV genotypes (group 1) were associated with squamous intraepitelial lesions (LSIL: HPV-39 (OR = 10.58, 95% CI 4.09-27.36, P < .001); HSIL: HPV-31 (OR = 14.76, 95% CI 6.56-33.20, P < .001); and CC: HPV-16 (OR = 25.01, 95% CI 18.83-33.21, P < .001). In multiple infections, the HPV genotypes (HPV-16 and HPV-18) were also associated with a high risk of lesions [LSIL: HPV-18 (OR = 3.45; 95% CI 1.36-8.91; P = .009); HSIL: HPV-18 (OR = 5.12; 95% CI 1.21-21.68; P = .026); and CC: HPV-16 (OR = 3.03; 95% CI 1.72-5.32; P < .001)] compared to single infection. In the analysis adjusted for age, giving birth, and cigarette smoking, a significant increase in the risk of LSIL, HSIL, and CC was maintained.

Conclusions: This study provides current data on the prevalence and distribution of HPV genotypes in women from southern Mexico, which could serve as a valuable reference to guide nationwide CC screening programs and provide scientific evidence that could be useful for vaccine development efforts. Likewise, it was identified that infection with carcinogenic HPV genotypes is an independent risk factor for LSIL, HSIL, and CC.

Keywords: Human papilloma virus; high-risk HPV; low-risk HPV; multiple-type HPV infection; probable high-risk HPV; single-genotype HPV infection; undifined-risk HPV.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Prevalence of HPV grouped by year in the study population. A) Prevalence of HPV groups. B) Prevalence of coinfections with 2 or 3 HPV genotypes. C) Prevalence of HR-HPV in patients with single infections. D) Prevalence of HR-HPV in patients with multiple infections. Human papillomavirus (HPV) types according to International Agency for Research on Cancer (IARC), Muñoz et al and Burk et al. High-risk HPVs (Group 1); Probable high-risk HPVs (Group 2); Low-risk HPVs (Group 3); Undefined-risk HPV. Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPV; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types.
Figure 2.
Figure 2.
Prevalence of HPV groups among patients with different cervical lesion grades. A) Prevalence of HPV groups in women No-IL. B) Prevalence of HPV groups in patients with LSIL. C) Prevalence of HPV groups in patients with HSIL. D) Prevalence of HPV groups in patients with CC. Human papillomavirus (HPV) types according to International Agency for Research on Cancer (IARC), Muñoz et al and Burk et al. High-risk HPVs (Group 1); Probable high-risk HPVs (Group 2); Low-risk HPVs (Group 3); Undefined-risk HPV. Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPVs; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types; No-IL: non intraepithelial lesion; LSIL: Low-grade squamous intraepithelial lesion; HSIL: High-grade squamous intraepithelial lesion; CC: Cervical cancer.
Figure 3.
Figure 3.
Prevalence of HPVs among patients with different cervical lesion grades and with single infections. A) Prevalence of HPV genotypes in women No-IL. B) Prevalence of HPV genotypes in patients with LSIL. C) Prevalence of HPV genotypes in patients with HSIL. D) Prevalence of HPV genotypes in patients with CC. Human papillomavirus (HPV) types according to International Agency for Research on Cancer (IARC), Muñoz et al and Burk et al. High-risk HPVs (Group 1: HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and, 59); Probable high-risk HPVs (Group 2: HPV-26, 34, 53, 66, 67, 68, 69, 70, 73, and 82); Low-risk HPVs (Group 3: HPV-6, 11, 13, 40, 42, 43, 44, 54, 61, 72, 81, and 89; Undefined-risk HPVs (HPV-7, 32, 55, 57, 62, 71, 74, 83, 84, 86, 87, 90, and 102). Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPV; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types; No-IL: non intraepithelial lesion; LSIL: Low-grade squamous intraepithelial lesion; HSIL: High-grade squamous intraepithelial lesion; CC: Cervical cancer.
Figure 4.
Figure 4.
Prevalence of HPV grouped by age in patients with single infections. A) prevalence of HR-HPVs infection in No-IL women in each age group. B) prevalence of HR-HPVs infection in LSIL patients in each age group. C) prevalence of HR-HPVs infection in HSIL patients in each age group. D) Prevalence of HR-HPVs infection in CC patients in each age group. Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPV; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types; No-IL: non intraepithelial lesion; LSIL: Low-grade squamous intraepithelial lesion; HSIL: High-grade squamous intraepithelial lesion; CC: Cervical cancer.
Figure 5.
Figure 5.
Prevalence of HPVs among patients with different cervical lesion grades and with multiple infections. A) Prevalence of HPV genotypes in women No-IL. B) Prevalence of HPV genotypes in patients with LSIL. C) Prevalence of HPV genotypes in patients with HSIL. D) Prevalence of HPV genotypes in patients with CC. Human papillomavirus (HPV) types according to International Agency for Research on Cancer (IARC), Muñoz et al and Burk et al. High-risk HPVs (Group 1: HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and, 59); Probable high-risk HPVs (Group 2: HPV-26, 34, 53, 66, 67, 68, 69, 70, 73, and 82); Low-risk HPVs (Group 3: HPV-6, 11, 13, 40, 42, 43, 44, 54, 61, 72, 81, and 89; Undefined-risk HPVs (HPV-7, 32, 55, 57, 62, 71, 74, 83, 84, 86, 87, 90, and 102). Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPV; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types; No-IL: non intraepithelial lesion; LSIL: Low-grade squamous intraepithelial lesion; HSIL: High-grade squamous intraepithelial lesion; CC: Cervical cancer.
Figure 6.
Figure 6.
Prevalence of HPV grouped by age in patients with multiple infections. A) Prevalence of HR-HPVs infection in No-IL women in each age group. B) prevalence of HR-HPVs infection in LSIL patients in each age group. C) prevalence of HR-HPVs infection in HSIL patients in each age group. D) Prevalence of HR-HPVs infection in CC patients in each age group. Abbreviations: HPV: Human papillomavirus; HR-HPV: high-risk HPV; pHR-HPV: probable high-risk HPV; LR-HPV: low-risk HPV; UR-HPV: Undefined-risk HPV; M-HPV: multiple HPV types; No-IL: non intraepithelial lesion; LSIL: Low-grade squamous intraepithelial lesion; HSIL: High-grade squamous intraepithelial lesion; CC: Cervical cancer.
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