Molecular detection of human papillomavirus prevalence in clinically normal females and identification of high-risk HPV 16 and 18 under low resources setting: a cohort study from Sri Lanka.

High oncogenic risk types of human papillomaviruses are mainly transmitted via sexual contact and are the main cause of cervical cancer in females in developing countries. Molecular detection of HPV infection enables early cancer detection; however, it is not widely used in low-income countries due to resource constraints. The aim of this study was to assess economical yet sensitive HPV detection and genotyping assays for both physician and self-collected cervical samples in a resource limited diagnostic setting. A previously reported polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) based HPV detection and genotyping protocol was verified using direct DNA sequencing to accurately identify the HPV 16 and 18 genotypes in a routine-diagnostic set-up. Then the HPV prevalence in a cohort of 433 clinically normal females was performed using PCR-RFLP diagnostic tool. Finally, the performance of the PCR-RFLP HPV screening tool was further evaluated against self-collected samples. HPV 16 and 18 genotyping with the PCR-RFLP consistently agreed with the sequencing data. The HPV prevalence in the screening cohort was 5.8%. HPV 16 and 18 were the most common high-risk HPV genotypes detected in the study cohort. Self-sampling vs physician collected samples from the same subject resulted in an overall concordance of 93% for HPV detection. The PCR-RFLP protocol can be used effectively under low resource settings for HPV 16/18 diagnosis and genotyping. The self-sampling approach can be recommended to increase HPV screening among women in Sri Lanka.

Supplementary information: The online version contains supplementary material available at 10.1007/s13337-024-00875-w.