The Uganda study on HPV variants and genital cancers

Background: Genital cancers in Uganda have been the most frequently diagnos ed cancer in men as well as in women since the 1950s. Genetic studies have detected HPV-16 variants of Af1 class and identified a new sub-class design ated Af1-u. Objectives: The main goal of this study is to analyze the preva lence of HPV strains and HPV variants in anogenital lesions of Ugandan male and female subjects in order to possibly determine their role in the patho genesis of such lesions and to develop an Ugandan preventive HPV vaccine pr ogram. Study design: The study is planning to enroll male and female subjec ts affected by genital lesions, in particular to collect 200 scrapes/biopsi es from women with normal ectocervical epithelium as well as with all diffe rent degrees of ectocervical lesions (from CIN 1/LSIL to cervical carcinoma ). All samples are analyzed by PCR amplification of the L1 conserved region (nt 6584-7035) and the E6/E7 genes (nt 34-880), nucleotide sequence analys is, homology and phylogenetic studies. Variant distribution studies will be followed by serological studies of prevalence and incidence in 1000 women. Preliminary Results and Conclusions: Penile cancers from the Kyadondo Coun ty have been analyzed for the presence of HPV sequences. More recently 16 e ctocervical scrapes and three biopsies have been received from women attend ing the Nsambya Hospital and analyzed for the presence and type of HPVs. Ou r results, obtained by PCR and sequencing analysis, allowed the identificat ion of HPV-16 Af1 sequences in 100% of tumor tissue and in 6.25% of scrapes . HPV 45 was identified only in one tumor together with HPV 16 infection. H PV 33 and HPV 58 were present in 20% and 40%, respectively of HPV positive benign samples. The results are showing a narrowing of the HPV pattern in m ore advanced lesions, suggesting that mainly HPV-16 Af1 patients are progre ssing to cancer. (C) 2000 Elsevier Science B.V. All rights reserved.