1 Department of Pathology

2 Department of Gynecology & Obstetric, College of Medicine, Kirkuk University


Background: Human papillomavirus (HPV) is a widely prevalent sexually transmitted virus. Because HPV is the causative agent of cervical cancer, knowledge of the epidemiology of HPV is critical. 
 Objective: To study the prevalence of high-risk human papillomavirus (HR-HPV) in cases of abnormal cervical cytology in Kirkuk city. 
Methods: In this prospective cross-sectional study, we collected 55 Pap smears samples from women attending Azadi Teaching Hospital and private clinics in Kirkuk over the period from 2012 to 2015. Two specimens were collected from each patient; one for a Pap smear study and the other for PCR assay to detect HPV. 
Results: HR-HPV was positive in 58.2% of patients. The HR-HPV positivity was highest in the age group 21-30 years (90.9%) and lowest at the age group ≥ 51 years (25%). The highest positive rate was in the group married at age 21-25 years (76.2%) and this rate decreased with progression of the marriage age until reaching (20%) in the age group married at ≥31 years. The largest group was para 3-4 (58.2%), followed by para 1-2 and nulliparous (29.1% and 9.1%, respectively). The highest positive rate was in the group para 3-4 (65.6%). Majority of the patients (67.3%) had ASC-US on cytological diagnosis, while LSIL and HSIL accounting for (18.2%) and (14.5%) respectively. The prevalence of HR-HPV infection rate increases with increasing the grade of abnormality reaching to (80%) and (87.5%) in cases of LSIL and HSIL respectively, while the positivity for ASCUS was ranking (45.9%), which was statistically significant (P-value=0.029), although the positivity in cases of HSIL was more than in the cases of LSIL the difference was statistically not significant (P-value =0.671). 
Conclusion: It is worthy to add HR-HPV screen by PCR to Pap test to increase the sensitivity of primary screening for cervical cancer. Key words: Abnormal Pap smears, HPV