Low-cost HPV testing and the prevalence of cervical infection in asymptomatic populations in Guatemala

ABSTRACT Background A low cost and accurate method for detecting high-risk (HR) HPV is important to permit HPV testing for cervical cancer prevention. We validated a low-cost commercially available HPV method (H13, Hybribio, Hong Kong) and determined the distribution of HPV infections in over 1717 cancer-free women in Guatemala. Methods H13 results were compared with two more established HPV tests: (Xpert™ (Cepheid) and SPF10-LIPA 25 ™ (DDL)) in 40 mainly known positive specimens. HR-HPV was detected in cervical samples from 1717 cancer-free women receiving Pap smears using the Hybribio™ realtime PCR assay of 13 HR types. Selected HPV positive samples were sequenced to determine viral type. Results The Hybribio H13 Assay showed 93% identical results with Xpert, and 89% with SPF10-LIPA 25 . A total of 13% (226/1717) of women tested HPV+. The highest prevalence was found in younger women (<30 years, 22 %) and older ones (≥60 years, 15%). The six most common HR-HPV types among the 148 HPV+ typed were HPV16 (22%), HPV18 (11%), HPV39 (11%), HPV58 (10%), HPV52 (8%), and HPV45 (8%). Conclusions The Hybribio Assay was low cost, and accurate in testing for HR-HPV infection. As in most places, HPV16 was the most prevalent HR type in Guatemala and the age-specific prevalence curve peaked in younger ages. Highlights A low cost and accurate method, Hybribio Assay, could be used for CC testing in low income regions. A total of 13% of cancer-free women were HPV+ and positivity was associated with younger age (<30 years old) in Guatemala. HPV16 was the major prevalent type.