Distribution of 14 high risk HPV types in cervical intraepithelial neoplasia detected by a non-radioactive general primer PCR mediated enzyme immunoassay

Aim-To evaluate the presence of high risk human papillomaviruses (HPV) in c ervical smears showing intraepithelial neoplasia (CIN). Methods-The presence of 14 high risk HPV was evaluated in 114 cervical smea rs with CIN of different degrees, by comparing a non-radioactive polymerase chain reaction (PCR) enzyme immunoassay (EIA) with conventional PCR follow ed by radioactive Southern blot hybridisation. General primer PCR amplicons detecting low risk and high risk HPV were typed for 14 different high risk HPV types (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) by a non-radioactive PCR-EIA. Virus load of HPV 16 positive CIN was assess ed using the semiquantitative PCR-EIA. Results-Histological evaluation confirmed CIN I in 49 cases (mean age 29.0 years, range 17 to 52), CIN II in 31 cases (mean age 30.8 years, 18 to 54), and CIN III in 33 cases (mean age 31.1 years, 16 to 57). The non-radioacti ve PCR-EIA showed an overall agreement rate of 90% (kappa value 0.75) when compared with conventional general primer PCR followed by radioactive South ern blot hybridisation. High risk HPVs were detected in 47% of CIN I, 77% o f CIN II, and 97% of CIN III (p less than or equal to 0.02). HPV types 39, 51, 56, and 58 were found in CIN I exclusively (between 2% and 8%). HPV 16 and HPV 31 were detected in 12% and 2% of CIN I, 35% and 21% of CIN II, and 74% and 13% of CIN III, respectively (p less than or equal to 0.03 and p l ess than or equal to 0.04). The virus load estimated by the semiquantitativ e PCR-EIA of HPV 16 was similar in CIN I, CIN II, and CIN III. Conclusions-The PCR-EIA has high clinical sensitivity for detecting CIN II/ III (90%). There was a significantly higher prevalence rate of HPV 16 and 3 1 in CIN III than in CIN I and II.