Following the wide diversity of population, ranging from Bangkok metropolitan women to hill tribe females, Thailand is considering future use of HPV primary screening, especially in the country’s northern rural areas. With high and sophisticated mountains and villages of Nan province, most females in this area were poor and lack of opportunity to achieve high technology of medical services. Whilst, there are currently unavailable and very limited data on HPV infection among Thai hill tribe women. This study aims to determine the prevalence and distribution of HPV types among Thai hill tribe females living in Tha Wang Pha, Pua, and Bo Kluea districts of Nan province, Thailand
A community-based sample of Thai hill tribe women, aged 30-60 years, were recruited from 3 districts in Nan province, Thailand during the period of November, 9-12, 2015. A total of 712 women were enrolled to participate in the cervical cancer screening program using Surepath liquid-base cytology (BD, Becton and Dickinson) and Cobas 4800 HPV DNA testing (Roche, USA) followed by Linear array HPV genotyping test (Roche, USA) in HPV high risk (HR) non 16, 18 cases. Forty-four (6.2 %) women were excluded and 10 specimens (1.4 %) were inadequate for HPV result interpretation.
Of the 658 eligible women, 5.0 % were positive for high risk HPV by Cobas 4800 HPV DNA testing. The overall prevalence of HR-HPV type 16, 18, non 16/18 was 1.1 %, 0.3 %, and 3.8 %, respectively. Using genotyping test, the most common detected HR-HPV types excluding type 16, 18 were HPV-39 (0.9 %), HPV-66 (0.9 %), HPV-58 (0.8%), HPV-51 (0.5 %), and HPV-52 (0.5%). The abnormal PAP were found in 19 women (2.9%). The most common abnormal PAP included LSIL (1.4%), ASC-US (1.1%), ASC-H (0.3%) and HSIL (0.2%), respectively.
The most common HR-HPV genotype in this Thai hill tribe cohort was HPV-16, followed by HPV-39, HPV-66, HPV-58, HPV-51, HPV-52, and HPV-18. The prevalence of HR-HPV infection among hill tribe females in this study is quite low, compared with other studies in the western countries. Our results suggest using the HPV screening with triage by cytology in this population may lower unnecessary cervical cytology up to 95 %, leading to a potential benefit for supporting the use of HPV primary screening in Thailand.