Assessment of Human Papilloma Virus infection in cervical epithelium of Kashmiri women

Human Papilloma Virus (HPV) infection is estimated to be the most common sexually transmitted infection. Because Human Papilloma Virus (HPV) is one of the causal factors in cervical cancer, understanding the epidemiology of this infection is an important step towards developing strategies for prevention. The aim of the present study was to examine the HPV prevalence and distribution of high risk HPV 16 and HPV 18 in cervical smears in a sample of Kashmiri women attending a gynecological outpatient department at Lal Ded Hospital Srinagar and also to explore the determinants of the infection. A total of 210 women visiting the gynecology outpatient department with varied complaints were studied with mean age 37.7yrs. Most of the participating women had low level of education with 40.95% of women having ≤6 years of education, 37.6% of women having 6-12yrs of education and 21.42% of women having ≥12yrs of education. All the women were married. Around 62.85% were 18-25yrs of age at the time of marriage. Of the married women most (50.4%) had ≥4 number of full term pregnancies. About 48.09% of women had low monthly income. Oral contraceptive was the most common method of contraception (26.66%). It is noteworthy that almost half of the study participants did not use any contraceptive method (53.33%). DNA was extracted from all the samples and subjected to polymerase chain reaction, using consensus primers for HPV. The samples that were positive for HPV DNA were subsequently assessed for high-risk consensus primers, types 16 and 18. The overall HPV prevalence as observed in our study was 13.8% among our sample of Kashmiri females aged 19 to 57 years (n=210). HPV prevalence was 33.3% among females aged 19 to 27 years, 11.3% among women aged 28 to 37 years, 7.9% among women aged 39 to 47 years and 13.5% among women aged 48 to 57 years. The prevalence of HPV infection in Kashmiri women is similar as observed in other states of India. The age pattern of HPV prevalence of the study group showed a general decrease, there was statistically significant (P=0.038) differences in the age-specific rates of HPV DNA detection in the study women aged 18-57. A statistically higher prevalence of high-risk HPV was observed in low economic status (P=0.017) and rural groups (P=0.016). Statistically significant association was found between HPV prevalence with age (P=0.038), parity (P=0.037) and age at marriage (P=0.025). This preliminary study could become a useful data for laying guidelines for mass screening of HPV, treatment and prophylaxis in the local population