Molecular diagnosis of human papilloma virus (HPV) genotypes in women with genital warts in Mosul / Iraq
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Abstract
Human Papillomavirus (HPV) belongs to the Papillomaviridae family and can contribute to Cervical Cancer (CC). The present study aimed to investigate the genotypic distribution and prevalence of HPV using Phosphate Buffered Saline (PBS) embedded tissue, a cervical swab and a cervical brush in Viral transport medium (VTM) from women with different genital warts with no other disease in Mosul City/ Iraq. A total of 150 samples collected from women with genital warts infections were analyzed. A sequencing analysis of the amplified HPV L1 gene was made and compared with that of the National Center for Biotechnology Information (NCBI). The existence of HPV nucleic acid DNA was examined in all samples by Polymerase Chain Reaction (PCR) using MY09/MY11 and GP+5/GP+6 primers, and then HPV genotypes were identified in Macrogen (Macrogen Co., Seoul, Korea) BioEdit (version 7.2.5.0). From 150 (cervical swab, brush, and tissue) patients with genital warts, the distribution of HPV genotype frequency in females with vaginal warts was 127 patients (84.6%), 10 patients (8%) with High-Risk (HR-HPV) serotypes (4%) of each HPV (16 and 45), while the rest 117 patients (92%) with Low-Risk (LR-HPV) included 60.5% HPV11, 20.5% HPV6 and 11.% HPV10. For the first time in Mosul, Iraq, the study used PBS-embedded tissue from patients with various anogenital lesions to examine the prevalence and genotypic distribution of HPV.
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Keywords
Genital warts, Genotype, Human Papillomavirus (HPV), Phosphate Buffered Saline (PBS), Polymerase Chain Reaction (PCR)
References
Ağar, E. & Aker, S. Ş. (2023). Association of HPV and sexually transmitted infections among patients with genital warts and asymptomatic individuals: a cross-sectional study. European Journal of Gynaecological Oncology, 44(4). DOI:10.22514/ejgo.2023.048
Alacam, S. & Bakir, A. (2021). Human Papillomavirus prevalence and genotype distribution in cervical swab samples in Istanbul, Turkey. Journal of Infection in Developing Countries, 15(8), 1190–1196. https://doi.org/10.3855/jidc.14663.
Alizadeh, N., Golchai, J., Ghanbari, A., Golchai, B. & Zaresharifi, S. (2021). Genotype distribution of human papillomavirus in anogenital warts in Guilan province, northern Iran. Iranian Journal of Dermatology, 24(2),117-120. https://doi.org/10.22034/ijd.2020.251941.1236
Babi, A., Issa, T., Issanov, A., Akilzhanova, A., Nurgaliyeva, K., Abugalieva, Z. & Aimagambetova, G. (2021). Prevalence of high-risk human papillomavirus infection among Kazakhstani women attending gynecological outpatient clinics. International Journal of Infectious Diseases, 109, 8-16. https://doi.org/10.1016/j.ijid.2021.06.006
Bauer, H. M., Greer, C. E. & Manos, M. M. (1992). Determination of genital human papillomavirus infection by consensus PCR amplification. Diagnostic molecular pathology: a practical approach. Oxford University Press. Oxford , United Kingdom. 2, Page 132-152.
Bitarafan, F., Hekmat, M. R., Khodaeian, M., Razmara, E., Ashrafganjoei, T., Gilani, M. M. & Garshasbi, M. (2021). Prevalence and genotype distribution of human papillomavirus infection among 12 076 Iranian women. International Journal of Infectious Diseases, 111, 295-302. https://doi.org/10.1016/j.ijid.2021.07.071
Bondagji, N. S., Gazzaz, F. S., Sait, K. & Abdullah, L. (2013). Prevalence of high-risk human papillomavirus infections in healthy Saudi women attending gynecologic clinics in the western region of Saudi Arabia. Annals of Saudi Medicine, 33(1), 13-17. https://doi.org/10.5144/0256-4947.2013.13
Chen, Q., Qu, W., Zhao, Y., Shu, L., Wang, Y. & Chen, X. (2023). The prevalence of HPV among 164,137 women in China exhibited some unique epidemiological characteristics. Infectious Agents and Cancer, 18(1), 72. https://doi.org/10.1186/s13027-023-00553-4
De Oliveira, C. M., Fregnani, J. H. T. G., Carvalho, J. P., Longatto-Filho, A. & Levi, J. E. (2013). Human papillomavirus genotypes distribution in 175 invasive cervical cancer cases from Brazil. BMC Cancer, 13(357), 1-8. https://doi.org/10.1186/1471-2407-13-357
Deluca, G. D., Liotta, D. J., Corre, R. M., Basiletti, J. A., Pei, P. G., Colucci, M. C. & Picconi, M. A. (2021). Baseline prevalence and type distribution of Human papillomavirus in sexually active non-vaccinated adolescent girls from Argentina. Revista argentina de microbiología, 53(1), 1-10. https://doi.org/10.1016/j.ram.2020.06.004
Depuydt, C. E., Boulet, G. A. V., Horvath, C. A., Benoy, I. H., Vereecken, A. J. & Bogers, J. J. (2007). Comparison of MY09/11 consensus PCR and type‐specific PCRs in the detection of oncogenic HPV types. Journal Of Cellular And Molecular Medicine, 11(4), 881-891. https://doi.org/10.1111/j.1582-4934.2007.00073.x
Diakite, I., Martins, B., Owusu-Edusei, K., Palmer, C., Patterson-Lomba, O., Gomez-Lievano, A., Zion, A., Simpson, R., Daniels, V. & Elbasha, E. (2024). Structured Literature Review to Identify Human Papillomavirus's Natural History Parameters for Dynamic Population Models of Vaccine Impacts. Infectious Diseases and Therapy, 13(5), 965–990. https://doi.org/10.1007/s40121-024-00952-z
Fawzy, M., Nofal, E., Abdelkhalek, N. & Ehab, R. (2023). Intralesional bivalent and quadrivalent human papillomavirus vaccines didn't significantly enhance the response of multiple anogenital warts when co-administered with intralesional Candida antigen immunotherapy. A randomized controlled trial. Archives of Dermatological Research, 315(10), 2813–2823. https://doi.org/10.1007/s00403-023-02698-z
Ferrall, L., Lin, K. Y., Roden, R. B., Hung, C. F. & Wu, T. C. (2021). Cervical cancer immunotherapy: facts and hopes. Clinical Cancer Research, 27(18),4953-4973. https://doi.org/10.1158/1078-0432.CCR-20-2833
Garbuglia, A. R., Lapa, D., Sias, C., Capobianchi, M. R. & Del Porto, P. (2020). The use of both therapeutic and prophylactic vaccines in the therapy of papillomavirus disease. Frontiers in Immunology, 11(188),1-9 https://doi.org/10.3389/fimmu.2020.00188
Ghobadi, M., Fakhar, H. B. Z. & Shaghaghi, B. (2023). The Prevalence of Human Papillomavirus Genotypes in Women with Genital Warts Using Polymerase Chain Reaction (PCR). International Journal of Cancer Management, 16(1), 1-6 https://doi.org/10.5812/ijcm-111191.
Global Cancer Observatory: International Agency for Research on Cancer (World Health Organization). [Available from : https://gco.iarc.fr/Global strategy to accelerate the elimination of cervical cancer as a public health problem: World Health Organization;2020.[Availablerom: https://www.who.int/publications-detail redirect/9789240014107
Graham S. V. (2017). Keratinocyte Differentiation-Dependent Human Papillomavirus Gene Regulation.Viruses, 9(9),1-18 .https://doi.org/10.3390/v9090245
Gravitt, P. E., Peyton, C. L., Alessi, T. Q., Wheeler, C. M., Coutlee, F., Hildesheim, A. & Apple, R. J. (2000). Improved amplification of genital human papillomaviruses. Journal of Clinical Microbiology, 38(1),357-361.https://doi.org/10.1128/jcm.38.1.357-361.2000
Haręża, D. A., Wilczyński, J. R. & Paradowska, E. (2022). Human papillomaviruses as infectious agents in gynecological cancers. Oncogenic properties of viral proteins. International Journal of MolecularSciences, 23(3),1-30. https://doi.org/10.3390/ijms23031818.
Huang, Z., Yao, S., Zou, L., Xie, W., Xie, D., Li, W. & Shuai, J. (2024). Evaluation of HPV infection and presence of licensed HPV vaccine genotypes among genital warts in Foshan, China. Frontiers in Microbiology, 15, 1-13. https://doi.org/10.3389/fmicb.2024.1376141.
Jacobs, M. V., Snijders, P. J., Van Den Brule, A. J., Helmerhorst, T. J., Meijer, C. J. & Walboomers, J. M. (1997). A general primer GP5+/GP6 (+)-mediated PCR-enzyme immunoassay method for rapid detection of 14 high-risk and 6 low-risk human papillomavirus genotypes in cervical scrapings. Journal of clinical microbiology, 35(3), 791-795. https://doi.org/10.1128/jcm.35.3.791-795.1997
Khan, I., Harshithkumar, R., More, A. & Mukherjee, A. (2023). Human papilloma virus: an unraveled enigma of universal burden of malignancies. Pathogens, 12(4),1-24. https://doi.org/10.3390/pathogens12040564
Krashias, G., Koptides, D. & Christodoulou, C. (2017). HPV prevalence and type distribution in Cypriot women with cervical cytological abnormalities. BMC infectious diseases, 17(346), 1-10. https://doi.org/10.1186/s12879-017-2439-0.
Malik, S., Sah, R., Muhammad, K. & Waheed, Y. (2023). Tracking HPV infection, associated cancer development, and recent treatment efforts acomprehensivereview. Vaccines, 11(1),1-16. https://doi.org/10.3390/vaccines11010102.
McBride, A. A. (2022). Human papillomaviruses: diversity, infection and host interactions. Nature Reviews Microbiology, 20(2),95-108. https://doi.org/10.1038/s41579-021-00617-5
Medda, A., Duca, D.& Chiocca, S. (2021). Human Papillomavirus and Cellular Pathways: Hits and Targets. Pathogens, 10(3),1-23. https://doi.org/10.3390/pathogens10030262
Melón, S., Alvarez-Argüelles, M., & de Oña, M. (2013). Molecular diagnosis of Human Papillomavirus Infections. Human Papillomavirus and Related Diseases–From Bench to Bedside A Diagnostic and Preventive Perspective. InTech ,page 1-26. doi: 10.5772/55706
Moossavi M, Fereidouni M, Zardast M, Khazaei Z. & Ghanbarzadeh N. (2020) Genotype distribution of human papilloma virus among women with genital warts biopsies in southern Khorasan, eastern Iran. MetaGene.25,1-4 .https://doi.org/10.1016/j.mgene.2020.100720
Muderris, T., Afsar, I., Yıldız, A. & Varer, C. A. (2019). HPV genotype distribution among women with normal and abnormal cervical cytology in Turkey. Revista Española de Quimioterapia, 32(6), 516-524 http://www.ncbi.nlm.nih.gov/pmc/articles/pmc6913072/
Othman, A., Goreal, A. & Pity, I. (2022). Molecular Detection of Human Papillomaviruses in Formalin Fixed Paraffin Embedded Sections from Different Anogenital Lesions in Duhok-Iraq. Diagnostics, 12(10),1-10. https://doi.org/10.3390/diagnostics12102496
Oztürk, S., Kaleli, I., Kaleli, B. & Bir, F. (2004). Investigation of human papillomavirus DNA in cervical specimens by hybrid capture assay. Mikrobiyoloji bulteni, 38(3), 223-232. PMID: 15490841.
Petca, A., Borislavschi, A., Zvanca, M. E., Petca, R. C., Sandru, F.& Dumitrascu, M. C. (2020). Non-sexual HPV transmission and role of vaccination for a better future (Review). Experimental and Therapeutic Medicine;20(6),1-5. https://doi.org/10.3892/etm.2020.9316
Ramesh, P. S., Krishnamurthy, S., Shrestha, S. & Devegowda, D. (2020). Where do we Stand on the Molecular Diagnostics for the Detection of Human Papillomavirus? A Comprehensive Review. Journal of Clinical and Diagnostic Research,14 (7),1-6.DOI: 10.7860/JCDR/2020/44371.13825
Remmerbach, T. W., Brinckmann, U. G., Hemprich, A., Chekol, M., Kühndel, K. & Liebert, U. G. (2004). PCR detection of human papillomavirus of the mucosa: comparison between MY09/11 and GP5+/6+ primer sets. Journal Of Clinical Virology, 30(4), 302-308. https://doi.org/10.1016/j.jcv.2003.12.011
Sahiner, F., Gümral, R., Sener, K., Yiğit, N., Dede, M., Yapar, M. & Kubar, A. (2012). Investigation of HPV-DNA in cervical smear samples by two different methods: MY09/11 consensus PCR and type-specific real-time PCR. Mikrobiyoloji Bulteni, 46(4), 624-636. PMID: 23188576
Sand, F. L., Thomsen, L. T., Oernskov, D., Munk, C., Waldstroem, M. & Kjaer, S. K. (2024). Cervical human papillomavirus prevalence according to socioeconomic and demographic characteristics in a large Danish screening population. Scandinavian Journal of Public Health, 52(4),:502-510. doi:10.1177/14034948231168297
Stamataki, P., Papazafiropoulou, A., Elefsiniotis, I., Giannakopoulou, M., Brokalaki, H., Apostolopoulou, E. & Saroglou, G. (2010). Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic. BMC infectious diseases, 10(27),1-6. https://doi.org/10.1186/1471-2334-10-27
Tadlaoui, K. A., Hassou, N., Bennani, B. & Ennaji, M. M. (2020). Emergence of oncogenic high-risk human papillomavirus types and cervical cancer. In Emerging and Reemerging Viral Pathogens .Academic Press.page 39-570. https://doi.org/10.1016/B978-0-12-819400-3.00024-7
Wang, R., Guo, X. L., Wisman, G. B. A., Schuuring, E., Wang, W. F., Zeng, Z. Y., & Wu, S. W. (2015). Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China. BMC infectious diseases, 15(257), 1-10. https://doi.org/10.1186/s12879-015-0998-5
Wu, X., Wang, S., Li, M., Li, J., Shen, J., Zhao, Y. & Wu, X. (2020). Conditional reprogramming: next generation cell culture. Acta Pharmaceutica Sinica B, 10(8), 1360-1381. https://doi.org/10.1016/j.apsb.2020.01.011
Alacam, S. & Bakir, A. (2021). Human Papillomavirus prevalence and genotype distribution in cervical swab samples in Istanbul, Turkey. Journal of Infection in Developing Countries, 15(8), 1190–1196. https://doi.org/10.3855/jidc.14663.
Alizadeh, N., Golchai, J., Ghanbari, A., Golchai, B. & Zaresharifi, S. (2021). Genotype distribution of human papillomavirus in anogenital warts in Guilan province, northern Iran. Iranian Journal of Dermatology, 24(2),117-120. https://doi.org/10.22034/ijd.2020.251941.1236
Babi, A., Issa, T., Issanov, A., Akilzhanova, A., Nurgaliyeva, K., Abugalieva, Z. & Aimagambetova, G. (2021). Prevalence of high-risk human papillomavirus infection among Kazakhstani women attending gynecological outpatient clinics. International Journal of Infectious Diseases, 109, 8-16. https://doi.org/10.1016/j.ijid.2021.06.006
Bauer, H. M., Greer, C. E. & Manos, M. M. (1992). Determination of genital human papillomavirus infection by consensus PCR amplification. Diagnostic molecular pathology: a practical approach. Oxford University Press. Oxford , United Kingdom. 2, Page 132-152.
Bitarafan, F., Hekmat, M. R., Khodaeian, M., Razmara, E., Ashrafganjoei, T., Gilani, M. M. & Garshasbi, M. (2021). Prevalence and genotype distribution of human papillomavirus infection among 12 076 Iranian women. International Journal of Infectious Diseases, 111, 295-302. https://doi.org/10.1016/j.ijid.2021.07.071
Bondagji, N. S., Gazzaz, F. S., Sait, K. & Abdullah, L. (2013). Prevalence of high-risk human papillomavirus infections in healthy Saudi women attending gynecologic clinics in the western region of Saudi Arabia. Annals of Saudi Medicine, 33(1), 13-17. https://doi.org/10.5144/0256-4947.2013.13
Chen, Q., Qu, W., Zhao, Y., Shu, L., Wang, Y. & Chen, X. (2023). The prevalence of HPV among 164,137 women in China exhibited some unique epidemiological characteristics. Infectious Agents and Cancer, 18(1), 72. https://doi.org/10.1186/s13027-023-00553-4
De Oliveira, C. M., Fregnani, J. H. T. G., Carvalho, J. P., Longatto-Filho, A. & Levi, J. E. (2013). Human papillomavirus genotypes distribution in 175 invasive cervical cancer cases from Brazil. BMC Cancer, 13(357), 1-8. https://doi.org/10.1186/1471-2407-13-357
Deluca, G. D., Liotta, D. J., Corre, R. M., Basiletti, J. A., Pei, P. G., Colucci, M. C. & Picconi, M. A. (2021). Baseline prevalence and type distribution of Human papillomavirus in sexually active non-vaccinated adolescent girls from Argentina. Revista argentina de microbiología, 53(1), 1-10. https://doi.org/10.1016/j.ram.2020.06.004
Depuydt, C. E., Boulet, G. A. V., Horvath, C. A., Benoy, I. H., Vereecken, A. J. & Bogers, J. J. (2007). Comparison of MY09/11 consensus PCR and type‐specific PCRs in the detection of oncogenic HPV types. Journal Of Cellular And Molecular Medicine, 11(4), 881-891. https://doi.org/10.1111/j.1582-4934.2007.00073.x
Diakite, I., Martins, B., Owusu-Edusei, K., Palmer, C., Patterson-Lomba, O., Gomez-Lievano, A., Zion, A., Simpson, R., Daniels, V. & Elbasha, E. (2024). Structured Literature Review to Identify Human Papillomavirus's Natural History Parameters for Dynamic Population Models of Vaccine Impacts. Infectious Diseases and Therapy, 13(5), 965–990. https://doi.org/10.1007/s40121-024-00952-z
Fawzy, M., Nofal, E., Abdelkhalek, N. & Ehab, R. (2023). Intralesional bivalent and quadrivalent human papillomavirus vaccines didn't significantly enhance the response of multiple anogenital warts when co-administered with intralesional Candida antigen immunotherapy. A randomized controlled trial. Archives of Dermatological Research, 315(10), 2813–2823. https://doi.org/10.1007/s00403-023-02698-z
Ferrall, L., Lin, K. Y., Roden, R. B., Hung, C. F. & Wu, T. C. (2021). Cervical cancer immunotherapy: facts and hopes. Clinical Cancer Research, 27(18),4953-4973. https://doi.org/10.1158/1078-0432.CCR-20-2833
Garbuglia, A. R., Lapa, D., Sias, C., Capobianchi, M. R. & Del Porto, P. (2020). The use of both therapeutic and prophylactic vaccines in the therapy of papillomavirus disease. Frontiers in Immunology, 11(188),1-9 https://doi.org/10.3389/fimmu.2020.00188
Ghobadi, M., Fakhar, H. B. Z. & Shaghaghi, B. (2023). The Prevalence of Human Papillomavirus Genotypes in Women with Genital Warts Using Polymerase Chain Reaction (PCR). International Journal of Cancer Management, 16(1), 1-6 https://doi.org/10.5812/ijcm-111191.
Global Cancer Observatory: International Agency for Research on Cancer (World Health Organization). [Available from : https://gco.iarc.fr/Global strategy to accelerate the elimination of cervical cancer as a public health problem: World Health Organization;2020.[Availablerom: https://www.who.int/publications-detail redirect/9789240014107
Graham S. V. (2017). Keratinocyte Differentiation-Dependent Human Papillomavirus Gene Regulation.Viruses, 9(9),1-18 .https://doi.org/10.3390/v9090245
Gravitt, P. E., Peyton, C. L., Alessi, T. Q., Wheeler, C. M., Coutlee, F., Hildesheim, A. & Apple, R. J. (2000). Improved amplification of genital human papillomaviruses. Journal of Clinical Microbiology, 38(1),357-361.https://doi.org/10.1128/jcm.38.1.357-361.2000
Haręża, D. A., Wilczyński, J. R. & Paradowska, E. (2022). Human papillomaviruses as infectious agents in gynecological cancers. Oncogenic properties of viral proteins. International Journal of MolecularSciences, 23(3),1-30. https://doi.org/10.3390/ijms23031818.
Huang, Z., Yao, S., Zou, L., Xie, W., Xie, D., Li, W. & Shuai, J. (2024). Evaluation of HPV infection and presence of licensed HPV vaccine genotypes among genital warts in Foshan, China. Frontiers in Microbiology, 15, 1-13. https://doi.org/10.3389/fmicb.2024.1376141.
Jacobs, M. V., Snijders, P. J., Van Den Brule, A. J., Helmerhorst, T. J., Meijer, C. J. & Walboomers, J. M. (1997). A general primer GP5+/GP6 (+)-mediated PCR-enzyme immunoassay method for rapid detection of 14 high-risk and 6 low-risk human papillomavirus genotypes in cervical scrapings. Journal of clinical microbiology, 35(3), 791-795. https://doi.org/10.1128/jcm.35.3.791-795.1997
Khan, I., Harshithkumar, R., More, A. & Mukherjee, A. (2023). Human papilloma virus: an unraveled enigma of universal burden of malignancies. Pathogens, 12(4),1-24. https://doi.org/10.3390/pathogens12040564
Krashias, G., Koptides, D. & Christodoulou, C. (2017). HPV prevalence and type distribution in Cypriot women with cervical cytological abnormalities. BMC infectious diseases, 17(346), 1-10. https://doi.org/10.1186/s12879-017-2439-0.
Malik, S., Sah, R., Muhammad, K. & Waheed, Y. (2023). Tracking HPV infection, associated cancer development, and recent treatment efforts acomprehensivereview. Vaccines, 11(1),1-16. https://doi.org/10.3390/vaccines11010102.
McBride, A. A. (2022). Human papillomaviruses: diversity, infection and host interactions. Nature Reviews Microbiology, 20(2),95-108. https://doi.org/10.1038/s41579-021-00617-5
Medda, A., Duca, D.& Chiocca, S. (2021). Human Papillomavirus and Cellular Pathways: Hits and Targets. Pathogens, 10(3),1-23. https://doi.org/10.3390/pathogens10030262
Melón, S., Alvarez-Argüelles, M., & de Oña, M. (2013). Molecular diagnosis of Human Papillomavirus Infections. Human Papillomavirus and Related Diseases–From Bench to Bedside A Diagnostic and Preventive Perspective. InTech ,page 1-26. doi: 10.5772/55706
Moossavi M, Fereidouni M, Zardast M, Khazaei Z. & Ghanbarzadeh N. (2020) Genotype distribution of human papilloma virus among women with genital warts biopsies in southern Khorasan, eastern Iran. MetaGene.25,1-4 .https://doi.org/10.1016/j.mgene.2020.100720
Muderris, T., Afsar, I., Yıldız, A. & Varer, C. A. (2019). HPV genotype distribution among women with normal and abnormal cervical cytology in Turkey. Revista Española de Quimioterapia, 32(6), 516-524 http://www.ncbi.nlm.nih.gov/pmc/articles/pmc6913072/
Othman, A., Goreal, A. & Pity, I. (2022). Molecular Detection of Human Papillomaviruses in Formalin Fixed Paraffin Embedded Sections from Different Anogenital Lesions in Duhok-Iraq. Diagnostics, 12(10),1-10. https://doi.org/10.3390/diagnostics12102496
Oztürk, S., Kaleli, I., Kaleli, B. & Bir, F. (2004). Investigation of human papillomavirus DNA in cervical specimens by hybrid capture assay. Mikrobiyoloji bulteni, 38(3), 223-232. PMID: 15490841.
Petca, A., Borislavschi, A., Zvanca, M. E., Petca, R. C., Sandru, F.& Dumitrascu, M. C. (2020). Non-sexual HPV transmission and role of vaccination for a better future (Review). Experimental and Therapeutic Medicine;20(6),1-5. https://doi.org/10.3892/etm.2020.9316
Ramesh, P. S., Krishnamurthy, S., Shrestha, S. & Devegowda, D. (2020). Where do we Stand on the Molecular Diagnostics for the Detection of Human Papillomavirus? A Comprehensive Review. Journal of Clinical and Diagnostic Research,14 (7),1-6.DOI: 10.7860/JCDR/2020/44371.13825
Remmerbach, T. W., Brinckmann, U. G., Hemprich, A., Chekol, M., Kühndel, K. & Liebert, U. G. (2004). PCR detection of human papillomavirus of the mucosa: comparison between MY09/11 and GP5+/6+ primer sets. Journal Of Clinical Virology, 30(4), 302-308. https://doi.org/10.1016/j.jcv.2003.12.011
Sahiner, F., Gümral, R., Sener, K., Yiğit, N., Dede, M., Yapar, M. & Kubar, A. (2012). Investigation of HPV-DNA in cervical smear samples by two different methods: MY09/11 consensus PCR and type-specific real-time PCR. Mikrobiyoloji Bulteni, 46(4), 624-636. PMID: 23188576
Sand, F. L., Thomsen, L. T., Oernskov, D., Munk, C., Waldstroem, M. & Kjaer, S. K. (2024). Cervical human papillomavirus prevalence according to socioeconomic and demographic characteristics in a large Danish screening population. Scandinavian Journal of Public Health, 52(4),:502-510. doi:10.1177/14034948231168297
Stamataki, P., Papazafiropoulou, A., Elefsiniotis, I., Giannakopoulou, M., Brokalaki, H., Apostolopoulou, E. & Saroglou, G. (2010). Prevalence of HPV infection among Greek women attending a gynecological outpatient clinic. BMC infectious diseases, 10(27),1-6. https://doi.org/10.1186/1471-2334-10-27
Tadlaoui, K. A., Hassou, N., Bennani, B. & Ennaji, M. M. (2020). Emergence of oncogenic high-risk human papillomavirus types and cervical cancer. In Emerging and Reemerging Viral Pathogens .Academic Press.page 39-570. https://doi.org/10.1016/B978-0-12-819400-3.00024-7
Wang, R., Guo, X. L., Wisman, G. B. A., Schuuring, E., Wang, W. F., Zeng, Z. Y., & Wu, S. W. (2015). Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China. BMC infectious diseases, 15(257), 1-10. https://doi.org/10.1186/s12879-015-0998-5
Wu, X., Wang, S., Li, M., Li, J., Shen, J., Zhao, Y. & Wu, X. (2020). Conditional reprogramming: next generation cell culture. Acta Pharmaceutica Sinica B, 10(8), 1360-1381. https://doi.org/10.1016/j.apsb.2020.01.011
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Molecular diagnosis of human papilloma virus (HPV) genotypes in women with genital warts in Mosul / Iraq. (2024). Journal of Applied and Natural Science, 16(3), 1176-1182. https://doi.org/10.31018/jans.v16i3.5790
