Clinical and Experimental Vaccine Research

The Korean Vaccine Society (대한백신학회)
권호 표지
DOI QR코드

DOI QR Code

Possible different genotypes for human papillomavirus vaccination in lower middle-income countries towards cervical cancer elimination in 2030: a cross-sectional study

  • Tofan Widya Utami (Oncology Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia) ;
  • Andrijono Andrijono (Oncology Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia) ;
  • Andi Putra (Oncology Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia) ;
  • Junita Indarti (Social Obstetrics and Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia) ;
  • Gert Fleuren (Department of Pathology, Leiden University Medical Center) ;
  • Ekaterina Jordanova (Department of Pathology, Leiden University Medical Center) ;
  • Inas Humairah (Oncology Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia) ;
  • Ahmad Utomo (Department of Research and Development, Dharmais Cancer Center)
  • Received : 2021.12.19
  • Accepted : 2022.01.26
  • Published : 2022.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Human papillomavirus (HPV) genotype and age distribution of HPV infection were crucial for the national vaccination and screening program planning. However, there was a limited study providing these data in the normal cervix population. This study aimed to explore the HPV genotypes profile of women with clinically normal cervix based on Visual Inspection of Acetic Acid (VIA) test. Materials and Methods: A 7-year cross-sectional study was conducted from 2012 to 2018 in private and public health care centers in Jakarta. Subjects were recruited consecutively. Data were collected by anamnesis, VIA, and HPV DNA test using the polymerase chain reaction (PCR; SPF10-DEIA-LiPA25) method. HPV genotyping procedures include DNA extraction, PCR (SPF10-DEIA-LiPA25) using the HPV XpressMatrix kit (PT KalGen DNA, East Jakarta, Indonesia), and hybridization. The IBM SPSS ver. 20.0 (IBM Corp., Armonk, NY, USA) were used to analyze the data. Results: A total of 1,397 subjects were collected. Positive HPV-DNA tests were found in 52 subjects (3.7%); 67% were single and 33% were multiple HPV infections. HPV 52 was the most frequently detected HPV genotype, followed by HPV 39, 16, 18 74, 44, 31, 54, and 66, respectively. The highest HPV infections in this population were in the 31-40 and 41-50 years old group. Conclusion: This study suggested beneficial screening for women aged 31-50 years old. Instead of "original" nonavalent (HPV 16, 18, 6, 11, 31, 33, 45, 52, 58), the different "nonavalent" formula for HPV vaccines protecting against HPV 16, 18, 6, 11, 31, 39, 44, 52, 74 might be useful for Indonesian population. However, further multicenter studies with a huge sample size are still needed.

Keywords

Acknowledgement

This research is supported by the Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.

References

  1. Naizhaer G, Yuan J, Mijiti P, Aierken K, Abulizi G, Qiao Y. Evaluation of multiple screening methods for cervical cancers in rural areas of Xinjiang, China. Medicine (Baltimore) 2020;99:e19135. 
  2. Pan American Health Organization. Integrating HPV testing in cervical cancer screening programs: a manual for program managers. Washington (DC): Pan American Health Organization; 2016. 
  3. Demarco M, Hyun N, Carter-Pokras O, et al. A study of type-specific HPV natural history and implications for contemporary cervical cancer screening programs. EClinicalMedicine 2020;22:100293. 
  4. Hull R, Mbele M, Makhafola T, et al. Cervical cancer in low and middle-income countries. Oncol Lett 2020;20:2058-74. 
  5. Fontham ET, Wolf AM, Church TR, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin 2020;70:321-46. 
  6. Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. Lancet 2013;382:889-99. 
  7. Sousa H, Tavares A, Campos C, et al. High-risk human papillomavirus genotype distribution in the Northern region of Portugal: data from regional cervical cancer screening program. Papillomavirus Res 2019;8:100179. 
  8. Hoque MR, Haque E, Karim MR. Cervical cancer in low-income countries: a Bangladeshi perspective. Int J Gynaecol Obstet 2021;152:19-25. 
  9. Wang Z, Gu Y, Wang H, et al. Distribution of cervical lesions in high-risk HPV (hr-HPV) positive women with ASC-US: a retrospective single-center study in China. Virol J 2020;17:185. 
  10. Oyervides-Munoz MA, Perez-Maya AA, Sanchez-Dominguez CN, et al. Multiple HPV infections and viral load association in persistent cervical lesions in Mexican women. Viruses 2020;12:380. 
  11. Moreno-Acosta P, Romero-Rojas A, Vial N, et al. Persistent high-risk HPV infection and molecular changes related to the development of cervical cancer. Case Rep Obstet Gynecol 2020;2020:6806857. 
  12. World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020. 
  13. Zeferino LC, Bastos JB, Vale DB, et al. Guidelines for HPV-DNA testing for cervical cancer screening in Brazil. Rev Bras Ginecol Obstet 2018;40:360-8. 
  14. Ogembo RK, Gona PN, Seymour AJ, et al. Prevalence of human papillomavirus genotypes among African women with normal cervical cytology and neoplasia: a systematic review and meta-analysis. PLoS One 2015;10:e0122488. 
  15. Utami TW, Aziz MF, Purwoto G, et al. Prevalence of high-risk human papillomavirus (HPV) among negative visual inspection of acetic acid (VIA). Indones J Obstet Gynecol 2014;2:153-6. 
  16. Husain RS, Ramakrishnan V. Global variation of human papillomavirus genotypes and selected genes involved in cervical malignancies. Ann Glob Health 2015;81:675-83. 
  17. Cuschieri KS, Cubie HA, Whitley MW, et al. Multiple high risk HPV infections are common in cervical neoplasia and young women in a cervical screening population. J Clin Pathol 2004;57:68-72. 
  18. Hariri S, Dunne E, Saraiya M, Unger E, Markowitz L. Human papillomavirus. In: Roush SW, Baldy LM, Hall MA, editors. Manual for the surveillance of vaccine-preventable diseases. 5th ed. Atlanta (GA): Centers for Disease Control and Prevention; 2011. p. 1-11. 
  19. Leaungwutiwong P, Bamrungsak B, Jittmittraphap A, et al. Molecular genotyping of human papillomavirus l1 gene in low-risk and high-risk populations in Bangkok. Sex Transm Dis 2015;42:208-17. 
  20. Wu Z, Li TY, Jiang M, et al. Human papillomavirus (HPV) 16/18 E6 oncoprotein expression in infections with single and multiple genotypes. Cancer Prev Res (Phila) 2019;12:95-102. 
  21. Li M, Du X, Lu M, et al. Prevalence characteristics of single and multiple HPV infections in women with cervical cancer and precancerous lesions in Beijing, China. J Med Virol 2019;91:473-81. 
  22. Wolday D, Derese M, Gebressellassie S, et al. HPV genotype distribution among women with normal and abnormal cervical cytology presenting in a tertiary gynecology referral clinic in Ethiopia. Infect Agent Cancer 2018;13:28. 
  23. Schellekens MC, Dijkman A, Aziz MF, et al. Prevalence of single and multiple HPV types in cervical carcinomas in Jakarta, Indonesia. Gynecol Oncol 2004;93:49-53. 
  24. Vet JN, de Boer MA, van den Akker BE, et al. Prevalence of human papillomavirus in Indonesia: a population-based study in three regions. Br J Cancer 2008;99:214-8. 
  25. Murdiyarso LS, Kartawinata M, Jenie I, et al. Single and multiple high-risk and low-risk human papillomavirus association with cervical lesions of 11,224 women in Jakarta. Cancer Causes Control 2016;27:1371-9. 
  26. Liu SS, Chan KY, Leung RC, et al. Prevalence and risk factors of human papillomavirus (HPV) infection in southern Chinese women: a population-based study. PLoS One 2011;6:e19244. 
  27. Atkinson A, Studwell C, Bejarano S, et al. Rural distribution of human papilloma virus in low- and middle-income countries. Exp Mol Pathol 2018;104:146-50. 
  28. Jaisamrarn U, Castellsague X, Garland SM, et al. Natural history of progression of HPV infection to cervical lesion or clearance: analysis of the control arm of the large, randomised PATRICIA study. PLoS One 2013;8:e79260. 
  29. Mesher D, Soldan K, Lehtinen M, et al. Population-level effects of human papillomavirus vaccination programs on infections with nonvaccine genotypes. Emerg Infect Dis 2016;22:1732-40. 
  30. Romero-Morelos P, Uribe-Jimenez A, Bandala C, et al. Genotyping of the human papilloma virus in a group of Mexican women treated in a highly specialist hospital: multiple infections and their potential transcendence in the current vaccination programme. Med Clin (Barc) 2017;149:287-92. 
  31. Chan PK, Ho WC, Chan MC, et al. Meta-analysis on prevalence and attribution of human papillomavirus types 52 and 58 in cervical neoplasia worldwide. PLoS One 2014;9:e107573. 
  32. Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer 2003;88:63-73. 
  33. Toh ZQ, Kosasih J, Russell FM, Garland SM, Mulholland EK, Licciardi PV. Recombinant human papillomavirus nonavalent vaccine in the prevention of cancers caused by human papillomavirus. Infect Drug Resist 2019;12:1951-67. 
  34. World Health Organization. WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva: World Health Organization; 2013.