High-risk HPV Types in Lesions of the Uterine Cervix of Female Commercial Sex Workers in the Philippines

In order to prevent cervical cancer, vaccines against human papilloma virus types 16 (HPV-16) and 18 (HPV-18) have been implemented worldwide. However, the HPV types that cause cancer can differ according to geographical area and ethnicity. In this new era of the HPV vaccine, it is important to elucidate the prevalent HPV types in each area. Therefore, the prevalence of HPV infection and cervical abnormalities among 369 female commercial sex workers in the Philippines were examined. HPV L1 gene was amplified by polymerase chain reaction (PCR) using modified GP5+/6+ primers, and genotyping was performed by sequencing cloned PCR products. HPV DNA was detected in 211 (57.2%) women, among whom 46 HPV types were identified. HPV-52 was most common and multiple-type infection was observed in 44.5%. Among 56 women with abnormal cervical cytology (low- and high-grade squamous intraepithelial lesions and adenocarcinoma in situ), HPV-52 was most common (23.2%), followed by HPV-16 (19.6%), -58 (10.7%), and -67 (10.7%). Only 27% of these women were positive for HPV-16 and -18. Multivariate analysis revealed that HPV-16, -39, -52, -67, and -82 were significantly associated with abnormal cytology. Repeated analysis of HPV-52 single-positive samples using the original GP5+/6+ PCR primers produced negative results in 57% of cases, suggesting that the prevalence of HPV-52 infection may have been underestimated in previous studies, and the current vaccines may not be sufficient for preventing infection and the development of premalignant lesions of the cervix in women in the Philippines.