Keywords :
Cost, End point nested multiplex polymerase chain reaction, Genotyping, Human papillomavirus, Hybrid capture
Citation Information :
SYMEC Research Group, Mukhopadhyay A, Mathai S, Bhaumik J, Bhattacharya S, Chandy M. Nested Multiplex Endpoint Polymerase Chain Reaction: An Alternative Method for Human Papilloma Virus Genotyping in Resource-limited Settings. 2024; 26 (1):1-6.
Purpose: Cervical cancer caused by human papillomavirus (HPV) is a public health problem.
The aim of the study was to develop a low-cost and reliable genotyping test of HPV for resource-limited settings.
Materials and methods: This observational study was done in a cancer hospital in eastern India.
Nonpregnant women with intact uteri (age: 25–65 years) were screened by testing their cervical swabs using the hybrid capture 2 (HC2) assay (HC2; Qiagen). HPV genotyping was done using a laboratory-developed test [LDT-nested multiplex endpoint polymerase chain reaction (PCR) assay]. The results of LDT were verified using HC2 genotypic assay (Qiagen). The t-test was used to ascertain statistical significance.
Results: A total of 253 out of 2,502 (10.11%) individuals tested positive for HPV by the HC2 assay. Out of these 253 HC2-positive samples, genotyping was successful by nested multiplex end point PCR in 182 (72%) of the samples. The commonest genotypes were the type 16 in 21.3% of samples and type 18 in 14.6% of samples. Among the non-16/18 genotypes, type 68 was the most prevalent (15.4% of samples). We detected single HPV genotypes in 123 out of 182 samples (68%), two genotypes in 44 out of 182 (24%), and three genotypes in 13 out of 182 (7%) samples. Two samples yielded four genotypes (1%). The cost of HPV genotyping by this nested multiplex endpoint PCR was Rs. 840 ($10.51). The cost of HPV genotyping by Sanger-based deoxyribonucleic acid (DNA) sequencing was Rs. 4,456 ($55.76), next-generation sequencing (NGS) Rs. 5,000 ($62.56), and that of HC2 test-based genotyping (using Qiagen kits) was Rs. 1,120 ($14.01) per positive sample.
Conclusion: The study provides important epidemiological information and shows that nested multiplex endpoint PCR-based methods may be used in HPV genotyping in resource-limited settings. The results are significant for surveillance and vaccination strategies.
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