Detecção e genotipagem de papilomavírus humano de alto risco em amostras cervicais de mulheres do município de Coari, Amazonas

Abstract

HPV infection is the most common sexually transmitted infection worldwide and the persistence of high-risk HPV (hrHPV) is the major etiologic factor for the development of Uterine Cervical Cancer (UCC). CCU is the fourth most common type of cancer in women in the world. In Brazil, it is the third most prevalent type and, in the North, it is the first neoplasm among women. Cytological examination has been the method of choice for the screening of precursor lesions and invasive cancer. Liquid cytology (CML) and molecular detection of HPV have been considered as promising strategies to increase the effectiveness of screening. This study aimed to detect hrHPV in women with altered cytology and in a group with normal cytology in the city of Coari-Amazonas. After consent, cervical samples were collected from 455 women under routine gynecological examination at the Basic Health Units of the city of Coari from September to December 2014. The samples were collected using the cytology collection kit in liquid medium - CML (BD SurePathTM). The cytopathological slides were prepared in the semi-automated BD PrepmateTM and PrepStainTM equipment. A 0.5 mL aliquot was separated to screen hrHPV by the HPV BD Onclarity® assay using the Viper LT system, which identifies six types individually (16/18/31/45/51/52) and eight types per group of genotypes ( P1: HPV33/58; P2: HPV56/59/66 and P3: HPV35/39/68). Our results showed that the blades made by CML were 99.3% classified as satisfactory and 7,3% (33/452) presented altered results. The hrHPV were detected in 70,9% of the cytologies altered, being positive in 77,3% of the cytologies classified as LSIL, 60% of the HSIL cytologies, 50% of the ASCUS cytologies and the most found genotypes were HPV 52 and group of HPV P3 genotypes. Among the 42 normal cytologies selected, 11,9% presented hrHPV infection, being also the most common genotypes HPV 52 and group of HPVP3 genotypes. These data, in addition to tracking women with a real risk for CCU development and confirming the presence and genotypic diversity of hrHPV in this Amazon female sample, reinforce studies in the literature that present CML and molecular tests as fundamental alternative tools in screening and, consequently, CCU reduction, especially in regions where there is a high index of this pathology.