Human Papillomavirus in Jordan—A selective study of 650 cases

Abstract

Objectives

To study the occurrence of Human Papillomavirus (HPV) in the community of Amman, Jordan through analyzing 650 samples randomly referred from community-based gynecology clinics during the years 2011-2023. Findings, including follow-up cases, were compared with those reported from within and outside this region.

Methods

This study used a liquid-based cytology technique. Samples from gynecology clinics underwent HPV genotyping by reverse transcription-polymerase chain reaction machine; next, a consultant pathologist reported on corresponding ThinPrep slides. Positive cases were stratified into high- or low-risk (HR-HPV or LR-HPV) genotypes, if the infection was single, multiple, or mixed HR-HPV with LR-HPV. Numbers, age distribution, and peak incidence of HPV in an Amman community were analyzed.

Results

A total of 644 women and six men (husbands) resident in Amman, all from gynecology clinics, showed HPV infection in 152 of 591 natives group I (25.7%), and 19 of 59 expatriates group II (23.2%). Group I showed 106 single, 38 double, seven triple, and one quadruple infection; 114 of 152 (75%) were HR-HPV; and 15 (9.9%) had mixed HR and LR-HPV. Group II showed 15 single, three double, and one triple infection; 15 of 59 (79%) in group II were HR-HPV, three (15.8%) mixed, and one LR-HPV. The most frequently found genotypes were 16 and 11 for HR-HPV and LR-HPV, respectively. Incidence of HPV occurred during ages 30-44 years in Jordanians and 25-49 years in expatriates. Abnormal cervical smear results with high- and low-grade neoplasia were seen in association with HR-HPV genotypes. HPV converted to negative in 22 of 61 (36%), average follow-up (FU) 2.8 years, and to positive in four (6.6%), 1.2-year average FU.

Conclusions

A selective study limited to Amman, Jordan indicates that cervical HPV, particularly HR-HPV infection, affects residents of Amman, Jordan, in whom cervical cancer ranks 10^th in women 15-44 years old. Any extrapolation on incidence rates awaits extension into other cities and rural zones of Jordan. Occurrence of HR-HPV genotypes and FU data justify promoting HPV vaccination programs to curb cervical cancer.