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Abstract
The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.
Highlights
Genital infection with human papillomavirus (HPV) is the most common sexually transmitted infection in women (Aral; Holmes, 1999)
In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania
Prevalence rates worldwide for HPV16 tend to be higher than those observed for other HPV types (Trottier and Franco, 2006; Hamzi Abdul Raub et al, 2014; Siriaunkgul et al 2014)
Summary
Genital infection with human papillomavirus (HPV) is the most common sexually transmitted infection in women (Aral; Holmes, 1999). About 50 of HPV types have a high tropism for the ano-genital mucosa and are sexually transmitted. Persistent infection with HR-HPV has been identified as the most important cause of cervical cancer (CC) (Clifford et al, 2003; Wang et al, 2013; Sengul et al, 2014). There are at least 15 oncogenic HR-HPV types that have been recognized as the cause of most CC (Smith et al., 2007; Bouvard et al, 2009). As an alternative to cervical cytology, HPV genotyping to identify HR-HPV in women with borderline pathology is recommended (Mandelblatt et al, 2002)
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