Human Papillomavirus in Jordan-A selective study of 650 cases

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.

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.

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.

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.