Serological prevalence and persistence of high-risk human papillomavirus infection among women in Santiago, Chile.

Felipe A Castro,Silvia Franceschi,Angelica Dominguez,Catterina Ferreccio,Klaus Puschel,Vanessa Van De Wyngard,Peter Jf Snijders,Michael Pawlita

doi:10.1186/1471-2334-14-361

Abstract

BackgroundHuman papillomavirus (HPV) serology is a main factor for designing vaccination programs and surveillance strategies; nevertheless, there are few reports of HPV seroprevalence in the general population, especially in Latin America. This study aimed to describe high-risk HPV serological prevalence, persistence, and association with concurrent cervical infection, in Chilean women.Methods1021 women from the general population, aged 15–85 years, were studied in 2001 of whom 600 were reexamined in 2006. The assessments at both time points included cervical HPV DNA testing, HPV antibody testing, cervical cytology and a sociodemographic/behavioral questionnaire. HPV DNA and antibodies against L1 protein of types 16, 18, 31, 33, 35, 45, 52, and 58 were assessed by reverse line blot and multiplex serology, respectively.ResultsSeropositivity was high at both baseline (43.2%) and follow-up (50.2%) and increased with age (p < 0.001); corresponding DNA prevalences were 6.7% and 8.7%. DNA and seroprevalence were associated at baseline (p = 0.01 for any HPV). Early age at first sexual intercourse and having had two or more sexual partners were independently associated with seropositivity. Most (82.0%) initially seropositive women remained seropositive at follow-up; 21.6% of initially seronegative women seroconverted, reaching 17.5% among women older than 60 years of age. ASCUS or worse cytology was correlated with HPV DNA positivity but not with HPV seropositivity.ConclusionHPV seroprevalence studies are a useful tool for learning about the dynamics of HPV infection in a community. This study contributes to understanding the natural history of HPV infection and provides a baseline assessment before the incorporation of HPV vaccination into a national program.

Highlights

Human papillomavirus (HPV) serology is a main factor for designing vaccination programs and surveillance strategies; there are few reports of HPV seroprevalence in the general population, especially in Latin America
Baseline seropositivity was compared with concurrent cervical DNA positivity to assess concordance, which can only be examined at the type-specific level, as women are often infected with multiple types of HPV and the concordance status can be different for each type
A second HPV DNA prevalence peak has been reported as well in other populations; it is not clear whether this is the result of incident infections due to new sexual partners, the reactivation of a latent infection associated to immunological changes, or the result of a subgroup of the population that had a higher exposure to HPV in their lifetime [31]

Summary

Introduction

Human papillomavirus (HPV) serology is a main factor for designing vaccination programs and surveillance strategies; there are few reports of HPV seroprevalence in the general population, especially in Latin America. This study aimed to describe high-risk HPV serological prevalence, persistence, and association with concurrent cervical infection, in Chilean women. Human papillomavirus (HPV) is the most common sexually transmitted infection in the world and persistent infection with high-risk HPV (HR-HPV) types is a necessary cause of cervical cancer [6]. A population-based survey of adult Chilean women reported an overall prevalence of HR-HPV genital infection (any oncogenic type) of 15%, with the highest prevalence observed in women under 25 years old [7]. A subsequent study confirmed that, among women in Santiago, Chile, cervical infection with HR-HPV peaks at young ages (< 20 years old) and steadily decreases to stabilize around age 40 years, and increases again after age 60 years [8]

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