Molecular Detection of Human Papillomavirus Genotype 16 and 18 in Women with Cervical Abnormalities in Osogbo South West Nigeria

Abstract

Aim: Cervical cancer, a potentially preventable disease poses a disproportionate high burden of incidence and mortality in low-middle income (LMIC) country due to suboptimal linkages for confirmatory diagnosis and subsequent treatment in many LMIC's. This study investigates the prevalence of high-risk HPV genotypes 16 and 18 in women with cervical abnormalities in Osogbo, South West Nigeria. Method: A cross-sectional study conducted on 221 women aged 18-65 who attended UniOsun Teaching Hospital for cervical screening in 2023. Cytology was performed using the Papanicolaou staining method and classified with the 2014 Bethesda system, while HPV DNA was detected using real-time PCR. Results: Out of 221 women, 135 (61.1%) had normal cytology, while 86 (38.9%) had abnormalities, including 39 (17.65%) with Low-grade Squamous Intraepithelial Lesions (LSIL), 28 (12.67%) with High-grade Squamous Intraepithelial Lesions (HSIL), and 19 (8.60%) with Atypical Squamous Cells of Undetermined Significance (ASC-US). Age-specific analysis indicated LSIL peaked in women aged 30-39, HSIL in those aged 40-49, and ASC-US in those aged 20-29. HPV 16 was found in 3 (1.4%) samples and HPV 18 in 2 (0.9%) samples, all from women with normal cytology. Conclusion: The study found no significant association between the presence of HPV 16/18 and cytological abnormalities (p>0.05), despite a high prevalence of HPV DNA across all cytology categories (75.0-79.5% for Relative Fluorescence Units) but without significant differences (p=0.977). This is supported by a meta-analysis, but contradicts a longitudinal study that showed higher HPV DNA levels were associated with increased risk of more severe cytological abnormalities. The study concluded that other high-risk HPV types or non-HPV factors may be involved in cervical pathogenesis in this region, and further research on a broader range of HPV genotypes and risk factors is needed to guide targeted screening methods.