High-risk human papillomavirus (HR-HPV) are responsible for cervical cancer (CC) which represents the second most prevalent gynecological cancer among Tunisian women. Preventive strategies against CC are based on prophylactic vaccines that have not yet been implemented into the national vaccination program of Tunisia. Therefore, the present study aimed to investigate the HPV genotypes distribution in cervical neoplasia in Tunisian women in order to predict the impact of using current HPV vaccines on cancer prevention in Tunisia. A total of 200 formalin-fixed paraffin embedded biopsies were collected in our study. DNA was extracted using Qiagen Mini prep kit. DNA quality was controlled by Beta Globin PCR. Only positive samples for Beta Globin test were used. HPV detection was performed by a nested PCR using PYGMY and GP5+/6+ primers. Genotyping was performed by Reverse Line hybridization using 31 probes. The mean age of participants was 38.97 years and 75% were over 30 years. Cervical neoplasia distribution according to age showed that CINII/CINIII was observed among women over 30 years old. All samples were positive for Beta Globin PCR. Overall HPV prevalence in cervical lesions was 83% (166/200). HPV was present in 65% of CINI, 82% of CINII/CINIII and 85% of CC. HR-HPV was statistically significantly associated with cervical intraepithelial neoplasia (p < 10–3). HR-HPV distribution according to lesion grade and cervical cancer showed that HPV16 and HPV18 were present in all lesions. For CINII/CINIII, HPV 35 (37.5%) was the most detected type, followed by HPV18 (33.3%) HPV 45 (28.5%) and HPV 16 (18.9%). HPV 45(57.5%), HPV 18 (53.3%) were the most detected in CC. HPV58, 59, 68 were only detected in CC and associated with HPV45, 18 and HPV16. HPV39, 31, 33, 52, 56 and HPV70 was associated only with CINI. Our findings can give useful information for vaccine implementation by helping the health policymakers to choose the most appropriate vaccine type in Tunisia.

中文翻译：

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人乳头瘤病毒在突尼斯女性癌前病变和宫颈癌变中的分布

高危人乳头瘤病毒 (HR-HPV) 是宫颈癌 (CC) 的罪魁祸首，这是突尼斯妇女中第二大流行的妇科癌症。针对 CC 的预防策略基于尚未在突尼斯国家疫苗接种计划中实施的预防性疫苗。因此，本研究旨在调查突尼斯妇女宫颈瘤形成中 HPV 基因型的分布，以预测使用当前 HPV 疫苗对突尼斯癌症预防的影响。我们的研究共收集了 200 份福尔马林固定石蜡包埋活检。使用 Qiagen Mini prep kit 提取 DNA。DNA 质量由 Beta Globin PCR 控制。仅使用 Beta Globin 测试的阳性样品。使用 PYGMY 和 GP5+/6+ 引物通过巢式 PCR 进行 HPV 检测。使用 31 个探针通过反向线杂交进行基因分型。参与者的平均年龄为 38.97 岁，75% 的人超过 30 岁。根据年龄的宫颈瘤形成分布表明，在 30 岁以上的女性中观察到 CINII/CINIII。所有样品均呈 Beta Globin PCR 阳性。宫颈病变中的总体 HPV 患病率为 83% (166/200)。HPV 存在于 65% 的 CINI、82% 的 CINII/CINIII 和 85% 的 CC 中。HR-HPV 与宫颈上皮内瘤变有统计学显着相关性（p < 10-3）。根据病变分级和宫颈癌的 HR-HPV 分布显示，所有病变中均存在 HPV16 和 HPV18。对于 CINII/CINIII，HPV 35 (37.5%) 是检出率最高的类型，其次是 HPV18 (33.3%) HPV 45 (28.5%) 和 HPV 16 (18.9%)。HPV 45（57.5%）、HPV 18（53.3%）在CC中检出率最高。HPV58, 59, 68 只在 CC 中检测到并与 HPV45、18 和 HPV16 相关。HPV39、31、33、52、56 和 HPV70 仅与 CINI 相关。我们的研究结果可以帮助卫生政策制定者在突尼斯选择最合适的疫苗类型，从而为疫苗实施提供有用的信息。