Aptima HPV Genotypes in Abnormal Cervical Samples in Different Age Groups – Implication on Vaccination Strategies

Abstract

Context: Persistent infection with high-risk human papillomavirus (hr-HPV) types is associated with high-grade cervical abnormalities. Aims: The aim of the study was to find most hr-HPV types causing persistent infection in abnormal cytological samples using Aptima HPV testing and discuss the compatibility of the Gardasil 9 vaccine in targeting most types. Settings: The study was conducted in a cytology laboratory in a tertiary hospital. Design: This is a retrospective observational study. Methods and Materials: Cytology and HPV Aptima test reports were obtained for abnormal cervical samples for a 6-year period. Statistical Analysis Used: Pearson Chi-square test. Results: Reports of 2834 abnormal cervical samples were analyzed. Aptima testing was positive in 21% of samples, including 92% of squamous cell carcinoma (SCC), 76.4% of the high-grade squamous intraepithelial lesion (HSIL), 52% of low-grade squamous intraepithelial lesion (LSIL), 40% of adenocarcinoma (ADC), and 21% of atypical squamous cells that cannot exclude HSIL (ASC-H). The Aptima other hr-HPV group was most common (60%), HPV16 was 26%, HPV18/45 was 9.6%, and double HPV infection was 4.3%. HPV16 was the most common infection in HSIL+ cases. HPV infection was most common in age groups (30–39) and (40–49), and a shift to age groups (50–59) and ≥60 was seen in HSIL+ cases. Conclusions: This study is the first of its kind in correlating age with hr-HPV and cytology findings in the Middle East and adds to previous knowledge related to the prevalence and Aptima testing of HPV. The outcome could be used as a baseline for the Gardasil 9 vaccine and for the assessment of its effectiveness after three or five years from initiation.