HPV 18 Variants in Women with Cervical Cancer in Northeast Brasil

Background: Human Papillomavirus (HPV) is the main etiological factor for the development of cervical cancer. HPV 18 is the second most frequent, accounting for up to 65% of all cases. HPV intratypic variation may influence the potential for progression to invasive cancer.The aim of this study was to evaluate the prevalence of human papillomavirus 18 intratypic variants in cervical cancer samples from women in the Northeast of Maranhão. Methods: The study was composed of 118 women over 18 years of age with a diagnosis of cervical cancer. Tumor fragments were collected and subjected to DNA extraction and Polymerase Chain Reaction (PCR) for HPV detection using the PGMY09/11 and GP+5/6 primers. Positive samples were submitted to automated sequencing for viral genotyping. To determine the HPV 18 lineages, positive samples were submitted to PCR, using specific primers to amplify the LCR and E6 regions of HPV 18 virus. Results: HPV was present in 88 women (73.3%), and HPV 16 was the most prevalent (48/54%), followed by HPV 18 (12/13.6%). Histologically, squamous cell carcinoma was predominant (79.1%). Among the HPV 18 variants identified, 10 (80%) belonged to lineage A, and sublineages A1, A2, A3, and A4. HPV 18 B variant (2/29%) was also detected, with the sublineages B1 and B2. In this study, the C variant was not found. There was no statistically significant association between the HPV 18 lineages found and sociodemographic and lifestyle variables (p > 0.05). Conclusions: Women with cervical cancer are associated with a higher frequency of HPV 16 and 18 in the Northeast region of Brazil, with a high prevalence of the lineage A among women with HPV 18.