Abstract
BackgroundInfection with Human Papillomavirus (HPV) is a necessary event in the multi-step process of cervical carcinogenesis. Little is known about the natural history of HPV infection among unscreened young adults. As prophylactic vaccines are being developed to prevent specifically HPV 16 and 18 infections, shifts in prevalence in the post vaccine era may be expected. This study provides a unique opportunity to gather baseline data before changes by nationwide vaccination occur.Methods and Principal FindingsThis cross-sectional study is part of a large prospective epidemiologic study performed among 2065 unscreened women aged 18 to 29 years. Women returned a self-collected cervico-vaginal specimen and filled out a questionnaire. All HPV DNA-positive samples (by SPF10 DEIA) were genotyped using the INNO-LiPA HPV genotyping assay. HPV point prevalence in this sample was 19%. Low and high risk HPV prevalence was 9.1% and 11.8%, respectively. A single HPV-type was detected in 14.9% of all women, while multiple types were found in 4.1%. HPV-types 16 (2.8%) and 18 (1.4%) were found concomitantly in only 3 women (0.1%). There was an increase in HPV prevalence till 22 years. Multivariate analysis showed that number of lifetime sexual partners was the most powerful predictor of HPV positivity, followed by type of relationship, frequency of sexual contact, age, and number of sexual partners over the past 6 months.Conclusions and SignificanceThis study shows that factors independently associated with HPV prevalence are mainly related to sexual behaviour. Combination of these results with the relative low prevalence of HPV 16 and/or 18 may be promising for expanding the future target group for catch up vaccination. Furthermore, these results provide a basis for research on possible future shifts in HPV genotype prevalence, and enable a better estimate of the effect of HPV 16-18 vaccination on cervical cancer incidence.
Highlights
Upcoming mass vaccination with Human Papillomavirus (HPV) vaccines will most certainly change HPV epidemiology
This study shows that factors independently associated with HPV prevalence are mainly related to sexual behaviour
Combination of these results with the relative low prevalence of HPV 16 and/or 18 may be promising for expanding the future target group for catch up vaccination. These results provide a basis for research on possible future shifts in HPV genotype prevalence, and enable a better estimate of the effect of HPV 16-18 vaccination on cervical cancer incidence
Summary
Upcoming mass vaccination with Human Papillomavirus (HPV) vaccines will most certainly change HPV epidemiology. Genital infection with the Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) among young sexually active women [1]. Most sexually active women (.50%) have been genitally infected by one or more HPV types at some point in their life [2]. Fourteen HPV genotypes are associated with cervical cancer development and are called high-risk (hrHPV). It has been estimated that the best results of prophylactic vaccination will be achieved by vaccinating women before they become genitally infected i.e. sexually active. Catch-up vaccination of already sexually active women is under consideration in many countries in order to get a faster decrease in cervical cancer incidence. This study provides a unique opportunity to gather baseline data before changes by nationwide vaccination occur
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