Advancing cervical screening through expanded genotyping: dominance of high-risk HPV type 52 in top clinic attendees

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ABSTRACT

  • 1Amissah KA,
  • 2Lebelo RL ,
  • 3Makua KS ,
  • 4Sibiya BJ ,
  • 5Nkwinika VV
  • 1Department of Virological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, South Africa
  • 2Department of Virological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, South Africa
  • 3Department of Virological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, South Africa
  • 4Department of Virological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, South Africa
  • 5Department of Virological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa

Background

Human Papillomavirus (HPV) is a leading cause of cervical cancer, with types 16 and 18 globally targeted by vaccines. In South Africa, rising rates of high-risk types such as HPV 35, 52, and 58, especially among young, sexually active women, threaten current prevention efforts. Termination of pregnancy (TOP) clinics provide a critical, often-missed opportunity for early detection. This study aimed to enhance cervical screening by applying expanded HPV genotyping in this high-risk population at a tertiary hospital in Tshwane

Method

This retrospective descriptive study analyzed cervical samples from 224 women aged 18 years and older who attended the TOP clinic between 2016 and 2018. Samples were collected in ThinPrep PreservCyt solution and previously undergone liquid based cytology (LBC) Pap testing and HPV DNA testing using the Abbott High-Risk HPV assay. For this study, stored DNA extracts were retested using the Seegene Allplex HPV28 Detection Assay for expanded genotyping. Statistical analysis was performed using Epi Info version 7.0

Result

All participants were black women, predominantly aged 18-30 years and residing in semi-urban areas. HPV DNA detection was higher with the Seegene assay (49.1%) compared to Abbott assay (37.5%). Among HPV-positive cases, 61.0% had high-risk HPV infections and 57.3% had multiple HPV infections. The most frequently detected high-risk types were HPV 52 (9.8%) and HPV 16 (9.4%), while HPV 54 (5.4%) was the most common low-risk type. Multiple infections predominated among women with abnormal cytology (11%), and high-risk types were found exclusively in women who presented with high-grade squamous intraepithelial lesions (HSIL).

Conclusion

Expanded genotyping revealed a high burden of high-risk HPV infections in young women, exposing gaps in the current screening program because this group is not screened. This approach improves early risk identification, guides follow-up care, and informs inclusive prevention strategies, including potential updates to vaccine coverage.
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PRESENTING AUTHOR

Mr. Kelvin Amissah, BSc Hons (MS) Virology (SMU)

Student, Sefako Makgatho Health Sciences University

Amissah Kelvin is currently pursuing a Master's degree in Virological Pathology, building on a strong foundation established during an Honours degree in the same field. His academic and research journey so far has been dedicated to understanding infectious diseases, such as the prevalence of Human papillomavirus infection, and their implications for screening, management, and prevention methods.

With a passion for bridging science and society, he has been in leadership both in academic environments and community settings. He aims to contribute to global health efforts through innovative research in pathogen surveillance and pandemic preparedness for infectious diseases.
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