Epidemiological and molecular studies have implicated the HPV as the main risk factor for the development of CIN and cervical cancer [1,2]. Persistent infection with high-risk HPV types and high viral load confer an increased risk for persistent or progressing CIN [3,4]. HPV testing, microbicidal agents that kill HPV and vaccines to protect against HPV are new strategies to detect and prevent cervical cancer. HPV testing has been suggested as a supplement to cytology (Papanicolau smears) in cervical cancer screening programs [5-7]. However, the management of the patients depending on HPV type identification requires characterization of the oncogenic potential of every individual HPV type.

At present there are 45 different HPV types known to infect the genital tract [8]. Papilloma viruses are defined by genomic sequence similarities [9]. An HPV genome is defined as a new type if it differs by more than 10% in its nucleotide sequence compared with other known types in the L1 open reading frame. HPVs that differ by 0 to 2% in their nucleotide sequence compared with the reference sequence of known HPV types are referred to as variants, and those that differ by 2 to 10% are referred to as subtypes. Based on their presence in normal, premalignant or malignant lesions, the genital HPV types have been classified into three groups: high-risk, intermediate-risk and low-risk [10]. HPV types 16 and 18, as well as some less prevalent HPV types, such as HPVs 45 and 56, belong to the group of high-risk HPV types due to their frequent detection in genital cancer. HPVs 31, 33, 35, 52, 58 and some others, are usually referred to as HPVs with an intermediate risk for tumor induction since they are more frequently detected in high-grade SIL than in cancers. HPVs 6 and 11, that are responsible for the great majority of condylomatous lesions and are very rarely found in genital cancers, and some rare HPV types, such as 42, 43 and 44, are considered as low-risk HPV types. For many new and rare HPV types, the oncogenic potential is still unknown due to the limited number of reports concerning their asso­ciation with particular dysplastic or neoplastic lesions.

HPV testing in the Republic of Macedonia was initiated in 1998 with the aim of determining the distribution of HPV types among Macedonian women with different cervical abnormalities, and to provide additional information for accurate decision-making in the treatment of cervical lesions.

Here we present the prevalence of a variant of the HPV type 66 in the Republic of Macedonia, the sequence variations of this HPV type among our patients and the association of HPV 66 with different cytological/ histological cervical lesions.