Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis.

Verônica Colpani,Eliana Márcia Wendland,Carla Magda Allan S Domingues,Frederico Soares Falcetta,Maicon Falavigna,Adele Schwartz Benzaken,Natália Luiza Kops,Ana Goretti Kalume Maranhão,Augusto Bacelo Bidinotto,Luciano Serpa Hammes,Marcia Edilaine Lopes Consolaro

doi:10.1371/journal.pone.0229154

Abstract

ObjectivesThis study aimed to estimate the prevalence of genital, anal and oral HPV infection in Brazil through systematic review and meta-analysis.MethodsWe searched EMBASE, LILACS, MEDLINE, Web of Science and SciELO from inception to December 2018. Original research articles that assessed the prevalence of genital (i.e., cervical, penile), anal and oral HPV infection in Brazil were selected in pairs by independent authors. No sex, age, HPV vaccination, language or date restrictions were applied. HPV prevalence was estimated and stratified according to risk factors population and by geographic area throughout the country. The study prevalence was pooled using a random effects model. Analysis was performed using R (version 3.5.2), packages meta version 4.9–4 and metaphor 2.0–0. This review is registered on PROSPERO under protocol number CRD42016032751.ResultsWe identified 3,351 references. After the screening process, 139 of them were eligible for this systematic review (57,513 total participants). Prevalence of cervical HPV was 25.41% (95% CI 22.71–28.32). Additionally, prevalence was 36.21% (95% CI 23.40, 51.33) in the penile region, 25.68% (95%CI 14.64, 41.04) in the anal region, and 11.89% (95%CI 6.26, 21.43) in the oral region. Subgroup analysis showed prevalence in each anatomic site was higher in high-risk populations.ConclusionThe prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile and anal region. Studies on HPV have primarily been developed to evaluate infection and cancer in the cervical region. There is a profound lack of HPV data in many geographic regions of Brazil and for different anatomic sites.

Highlights

Human papillomavirus (HPV) is a DNA virus from the Papillomaviridae family, comprising over 170 identified types [1]
139 of them were eligible for this systematic review (57,513 total participants)
The prevalence of HPV is high in the Brazilian population and varies by population risk and anatomic body site, with lower rates in the oral cavity compared to that in the cervical, penile

Summary

Introduction

Human papillomavirus (HPV) is a DNA virus from the Papillomaviridae family, comprising over 170 identified types [1]. HPV may infect skin and mucosal membranes among different anatomic sites such as the anogenital region and oral cavity [2]. The global prevalence of HPV infection is approximately 12% with substantial regional variation [3]. HPV is the most common sexually transmitted infection, with sufficient evidence of its carcinogenic effects at different sites [1,4]. HPV is responsible for 5.1% of the burden of cancer [6] and is present in nearly 100% of cervical tumors, 88% of anal tumors and 50% of penile tumors [4]. In head and neck squamous cell carcinomas, HPV-16 is the most commonly found genotype, while overall HPV prevalence in these lesions is 26% [7]

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