FC 19-06Detection of HPV- ZIKV Co-infections in Ecuadorian Women Using Two Real-Time PCR-based Methods in Cervical Cytology Samples

30. Sexually transmitted diseases and HIV infection
H. Zambrano 1, J. Waggoner 2, K. Leon 3, M. Schettino 4, V. Ketty 4, B. Pinsky 5, D. Vanden Broek 6.
1University of Gent (Belgium), 2Emory University (United States), 3Hospital Alfredo Paulson (Ecuador), 4Ministerio de Salud (Ecuador), 5Standford University (United States), 6Standford University (Belgium)

Background / Objectives

Human papillomavirus (HPV) is the cause of cervical cancer. Zika virus (ZIKV) infection during pregnancy has been linked to birth defects.  There is limited information about the detection of co-infections with these two pathogens.

We had the objective to detect the presence of HPV and ZIKV in cervical cytology specimens from 109 healthy women attending the Hospital Luis Vernaza (Guayaquil, Ecuador).

 


Methods

All samples were tested for high risk HPV genotypes (HPV-HR) using the Cobas HPV 480 and for ZIKV using a validated, laboratory-developed real-time RT-PCR (the ZCD assay).  Cobas HPV has specific call-outs for HPV 16 and HPV 18 and combines detection of the remaining 12 genotypes.


Results

Patient age range was 22 to 68 years, with a median of 39.34[JJW1] .  HPV DNA was detected in 19 women (17.43%).  Eighteen (16.51%) were positive for a single marker (HPV-HR, HPV-16 or HPV-18) while one (0.9%) was infected by both HPV-16 and HPV 18. ZIKV was detected in 18/109 (16.51%) patients. Of the ZIKV positive women, the majority were under the age of 45 (13/18[JJW2]  vs 5/18). We found 4 cases of HPV- ZIKV co-infection: two patients were positive for HPV-HR (ages 41 and 53) and one patient each was positive for HPV 16 (age 49) and HPV 18 (age 26).  All four women were asymptomatic from the ZIKV infection.


Conclusion

These data on ZIKV detection provide additional supporting evidence for female-male transmission and demonstrated to the potential utility of screening for ZIKV in cervical cytology specimens.  To the best of our knowledge, this is the first report of HPV-HR-ZIKV co-infections.


References

1: Aromseree S, Pientong C, Swangphon P, Chaiwongkot A, Patarapadungkit N,Kleebkaow P, Tungsiriwattana T, Kongyingyoes B, Vendrig T, Middeldorp JM,Ekalaksananan T. Possible contributing role of Epstein-Barr virus (EBV) as acofactor in human papillomavirus (HPV)-associated cervical carcinogenesis. J ClinVirol. 2015 Dec;73:70-6.

2: Vriend HJ, Bogaards JA, van Bergen JE, Brink AA, van den Broek IV, Hoebe CJ,King AJ, van der Sande MA, Wolffs PF, de Melker HE; Medical Microbiological Laboratories and the CSI group.. Incidence and persistence of carcinogenic genital human papillomavirus infections in young women with or without Chlamydia  trachomatis co-infection. Cancer Med. 2015 Oct;4(10):1589-98.

3: Waggoner JJ, Gresh L, Mohamed-Hadley A, Ballesteros G, Davila MJ, Tellez Y,Sahoo MK, Balmaseda A, Harris E, Pinsky BA. Single-Reaction Multiplex Reverse Transcription PCR for Detection of Zika, Chikungunya, and Dengue Viruses. Emerg Infect Dis. 2016 Jul;22(7):1295-7.

4: Zambrano H, Waggoner J, León K, Pinsky B, Vera K, Schettino M, Rivera L,Landivar J, Granda M, Lee A, Mor G. High incidence of Zika virus infection detected in plasma and cervical cytology specimens from pregnant women in Guayaquil, Ecuador. Am J Reprod Immunol. 2017 Feb;77(2).