Prevaccination Distribution of Human Papillomavirus Types in Italian Women with High-Risk Lesions and Cervical Neoplasia

Abstract

Objectives: The aim of this study was to determine both human papillomavirus (HPV) prevalence and type distribution in cervical specimens of women with cytological abnormalities and to establish the association with high-grade lesions and cervical neoplasia in order to estimate the impact of an HPV vaccine in this region. Methods: Four hundred and ninety-three cervical specimens obtained from women undergoing routine cervical screening by liquid-based Pap smear were analyzed by Roche linear array HPV genotyping to identify HPV genotypes. Results: HPV 16 was the genotype detected most frequently, followed by HPV 31, 33 and 52. Multiple infections were frequent (58.5%), but decreased with the increase of cervical severity. We found multiple infections composed by only LR types in 4 women: 3 had a histological diagnosis of cervical intraepithelial neoplasia (CIN) 3 and 1 a diagnosis of cervical cancer. HPV 16 alone was present in 24.6% of CIN 3 lesions and 40% of neoplasia. However, in our region, there are an additional 28% of cases of carcinoma in situ and 40% of cases of invasive cancer due to different HPV types that should be considered for eventual inclusion in second-generation HPV vaccines. Conclusions: These results highlight the importance of assessing individual types in the management and prediction of outcome of women with abnormal baseline cytology and may contribute to determine the potential efficacy of an HPV vaccine in clinical practice.