Purpose of Study Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are approximately 30 genital types of HPV, divided into low-risk (LR) types, which can lead to genital warts, and low-grade dysplasia and high-risk (HR) types, which, if persistent, can lead to cervical carcinoma. A new vaccine containing LR types 6/11 and HR types 16/18 has been licensed by the FDA for females 9 to 26. We evaluated the distribution of HPV genotypes present in our adolescent population with atypical cytology and HR HPV.
Methods Prealiquots were removed from all liquid Pap smear specimens collected at our clinics from girls between the ages of 10 and 20 who underwent Pap testing from March to June 2006. These were held pending cytology results and if reported as atypical cells of undetermined significance (ASCUS) were reflexed for Hybrid Capture-2TM (HC-2, Digene Corp.) screening for HR HPV. DNA was extracted from those specimens testing positive for HR HPV (n = 32), plus six negative controls using the QIAamp MinElute (QIAGEN). HPV genotyping was performed using the Multiplex Genotyping HPV Assay under development by Digene Corp. for the Luminex instrument (a kind gift from Renee Howell at Digene Corp.). Two LR and 17 HR HPV types are delineated with this method.
Results Genotype results were available for 28 of 32 HC-2-positive patients (2 specimens were inhibitory and 2 specimens had no detectable genotype) in addition to 1 of the HC-2-negative patients (this latter patient had a LR type not detected by HC-2) for a total of 29 patients with genotype results. More than one type was detected in 55% and more than two types were found in 24% of the girls. The most common types detected were HPV 16 (38%); HPV 31, 35, 45, 52, and 59 (each at 14%); and HPV 6, 11, 58, 66, and 68 (each at 10%). Less commonly detected were HPV 18 (9%) and one specimen each for HPV 26, 39, 56, and 73.
Conclusions Based on our preliminary study, about 47% of our adolescents with ASCUS cytology and HR HPV had evidence of incident infection with HPV genotypes found in the new vaccine.
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