TWO YEARS GENOTYPE DISTRIBUTION OF HUMAN PAPILLOMAVIRUS

IN CALABRIA REGION, SOUTHERN ITALY

Luisa Galati1, Cinzia Peronace1, Rosanna Masciari2, Cristina Giraldi3, Rosa Anna Leone4, Maria Teresa Fiorillo5, Giorgio Settimo Barreca1, Angelo Giuseppe Lamberti1, Aida Giancotti1, Pasquale Minchella 2, Maria Gabriella Lepore2, Francesca Greco3,

Maria Vittoria Mauro3, Vilma Villella 4, Annelisa Borelli 4, Giuseppa Lo Bocchiaro 5, Giovanni Surace 5 , Maria Carla Liberto1, Alfredo Focà1

1Institute of Clinical Microbiology, Department of Health Sciences, “Magna Graecia” University, Catanzaro, Italy, 2 Unit of Microbiology and Virology, “Pugliese-Ciaccio” Hospital, Catanzaro, Italy, 3 Unit of Microbiology and Virology, “Annunziata” 1Hospital, Cosenza, Italy, 4 Unit of Microbiology and Virology, General Hospital, Lamezia Terme, Italy, 5 Unit of Microbiology and Virology, Polo Sanitario Nord ASP 5, Reggio Calabria, Italy.

Human Papillomaviruses (HPV) are a group of DNA viruses commonly

transmitted by sexual activity. Genital HPV infection is responsible for both

asymptomatic and benign form or malignant lesions of the genital tract.

Persistent infection by high-risk HPV types (HR-HPV) causes development

of cervical lesions and cancer. Italian investigations on HPV prevalence in

healthy women and in women with cytological abnormalities reported that

HPV 16 is the most frequent High Risk genotype. However, local HPV types

distribution can be area-specific and it is necessary to determine genotypic

distribution in each area. Since in our region there is a lack of

epidemiological analysis on HPV type distribution, for the first time we

retrospectively collected data on HPV genotype in women attending the

major Hospitals in Calabria Region, Southern Italy.

Cervical specimens were collected from 3140 women using a cytobrush,

during the 2013-2014 periods, and tested for HPV genotypes by INNO-

LiPA® Genotyping Extra (Innogenetics, Belgium) and Linear Array® HPV

Genotyping (Roche, Italy). Cervical specimens were collected from each

patient using a cytobrush and stored at -20⁰ C until DNA extraction with

automated methods. Eluted DNA was used for PCR amplification of L1 gene

region and a fragment of the human-globin gene. Detection and genotype

determination were performed using denaturated amplified DNA and an

array of oligonucleotide probes, that permitted independent

identification of individual HPV types. This study was carried out by

Regional HPV Study Group.

This retrospective study represents the first report on the circulation of the different HPV genotypes in Calabria Region, Italy.

Data collection will allow us to generate and periodically check a dynamic picture of HPV epidemiology. These data may contribute to

increase our knowledge of HPV epidemiology in a vast Region of Southern Italy providing important evidences for establishing health

care policies and adequate vaccination programs.

On a total of 3140 tested women (aged 13-71), 571 (18.2%) were

positive for single HPV type, 460 (14.6%) for multiple infections and

2109 (67.2%) were negative (Fig.1). Among women with multiple

genotypes there were 231 with dual infection (50.2%), 128 with triple

infection (27.8%), 60 and 27 with 4 and 5 genotypes each (13% and

5.9% ) and 14 women with 6 or more HPV genotypes (3%) (Fig.2).

HPV single infection was most frequently found among women aged 20-

29 years and it decreased with advancing age; conversely HPV multiple

infection was commonly detected among women aged 30-49 years

(Fig.3). In addition, HPV infection was found most frequent among

women aged 20-39 years and decreased with increasing age.

In single and multiple infections, the mainly detected high-risk genotype

was HPV 16 that was found in 21.4% cases followed by HPV 31

(10.5%) and HPV 51 (8.3 %). Among low-risk HPV genotypes, HPV 42

(10.8%), HPV 6 (10.4%) and HPV CP6108 (8.1%) were the most

frequent types. There were also detected probable HR-HPV types 53 (12.

3%) and HPV 66 (7.6%).

RESULTS

Figure 1: Patients tested for HPV DNA.

REFERENCES

METHODS INTRODUCTION OBJECTIVES

CONLUSIONS

Figure 4: HPVgenotype recurrence in single or multiple infections.

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2 genotypes3

genotypes4

genotypes5

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Negative67.2 %

Positive single infection 18.2%

Positive multiple Infection

14.6%

Figure 2: Patients infected with multiple HPV types.

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<20 20-29 30-39 40-49 >50

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Age (years)

Serie3

Serie2

Single Infection Multiple infections

Figure 3: Positivity rates of single and

multiple HPV infections stratified for age

classes.

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2. Kantathavorn et al. Genotypic distribution of human papillomavirus (HPV) and cervical cytology findings in 5906 Thai women undergoing cervical cancer screening programs. . Infectious Agents and

Cancer (2015) 10:7.

3. Pietro Ammatuna Lucia Giovannelli, Domenica Matranga, Saverio Ciriminna, and Antonio Perino. Prevalence of Genital Human Papilloma Virus Infection and Genotypes among Young Women in Sicily,

South Italy. Cancer Epidemiol Biomarkers Prev 2008;17(8).

4. Nubia Munȭz, F. Xavier Bosch et al. Epidemiologic Classification of Human Papillomavirus Types Associated with Cervical Cancer. N. Engl. J. Med. 2003; 346:518-27.

5. De Francesco MA, Gargiulo F, Schreber C, et al. Detection and genotyping of human papillomavirus in cervical samples from italian patients. J Med Virol 2007;75:588-92.

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16 31 51 73 58 59 45 56 52 18 35 33 39 68 82 6 42 CP6108 62 61 54 84 81 40 83 55 11 70 64 67 71 72 53 66

%

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HPV genotypes

HR-HPV

LR-HPV

pHR-HPV