The incidence, clearance and persistence of non-cervical human papillomavirus infections: a systematic review of the literature.

Sylvia Taylor,Marina Bakker,Xavier Castellsagué,Eveline Bunge

doi:10.1186/s12879-016-1633-9

Abstract

BackgroundHuman papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need. However, HPV is also a major cause of non-cervical anogenital and oropharyngeal cancers and the potential benefit of vaccination likely extends beyond cervical cancer.MethodsA systematic literature search of PubMed (1995–2014) identified publications assessing the incidence, persistence, and clearance of non-cervical anogenital/oral HPV infections. Comparability with cervical HPV was assessed by identifying articles assessing the same or similar populations.ResultsAvailable data suggest high incidence rates of non-cervical HPV infection in men and women, with HPV-16 predominating in all sites. The incidence of high risk HPV per 100 person-years ranged from 11.4 to 72.9 for penile infections, 6.7–47.9 at other male genital sites, and 4.4–36.7 and 5.3–23.4 for anal infections in men and women, respectively. The incidence per 100 person-years of oral infection with any HPV type ranged from 5.7 to 6.7 in men and 6.8–39.6 in women. Within the limitations of the data, there was a general pattern of higher incidence and clearance of non-cervical genital HPV infections, compared to cervical infections. HIV status, circumcision, number of sex partners and partner HPV status significantly influenced high-risk HPV incidence/clearance at male anogenital sites. Few studies assessed risk factors for oral HPV.ConclusionsParallels appear to exist between the epidemiology of cervical and non-cervical HPV infections in terms of incidence, HPV-type distribution, and risk factors for infection. Available data suggest that non-cervical genital HPV infections may occur more frequently, with higher clearance rates, than cervical infections. More extensive studies could provide useful information for estimating vaccine impact, the wider cost-benefit of HPV vaccination, and guiding vaccination policy.Trial registrationNot applicable, as systematic review of the literature.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1633-9) contains supplementary material, which is available to authorized users.

Highlights

Human papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need
70 % of cervical cancers are caused by HPV types 16 and 18, which along with several other high risk HPV types (HR-HPV), can be prevented by vaccination
Among the 31 studies reporting data on incidence of any HPV or any High risk (HR)-HPV, 10 (32 %) used type-specific definitions which counted any newly detected type as an incident infection and 17 (55 %) used non-type-specific definitions that required subjects to be negative for any HPV or any HR-HPV at baseline; an additional 4 studies reported data on incidence of individual HPV types only

Summary

Introduction

Human papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need. Cervical cancer develops following persistent infection with oncogenic (or high risk) types of the human papillomavirus (HPV), that includes types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 [2]. 70 % of cervical cancers are caused by HPV types 16 and 18, which along with several other high risk HPV types (HR-HPV), can be prevented by vaccination. The incidence of cervical cancer is far higher than that of nongenital or oropharyngeal cancers, and the provision of HPV vaccines to prevent cervical cancer remains a public health priority. Together non-cervical and oropharyngeal cancers represented approximately 80,000 new HPVrelated cancer cases worldwide in 2008, signifying an important public health burden [6]

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