Prevalence Of High-risk Human Papillomavirus Infection Research Articles

Prevalence and Type Distribution of High-Risk Human Papillomavirus (HPV) in Breast Cancer: A Qatar Based Study.

Human papillomavirus (HPV) has been implicated in the etiology of a variety of human cancers. Studies investigating the presence of high-risk (HR) HPV in breast tissue have generated considerable controversy over its role as a potential risk factor for breast cancer (BC). This is the first investigation reporting the prevalence and type distribution of high-risk HPV infection in breast tissue in the population of Qatar. A prospective comparison blind research study herein reconnoitered the presence of twelve HR-HPV types’ DNA using multiplex PCR by screening a total of 150 fresh breast tissue specimens. Data obtained shows that HR-HPV types were found in 10% of subjects with breast cancer; of which the presence of HPV was confirmed in 4/33 (12.12%) of invasive carcinomas. These findings, the first reported from the population of Qatar, suggest that the selective presence of HPV in breast tissue is likely to be a related factor in the progression of certain cases of breast cancer.

Characterization of vaginal microbiota in Chinese women with cervical squamous intra-epithelial neoplasia

ObjectivesAlthough persistent human papillomavirus (HPV) infection is a major cause of cervical squamous intra-epithelial neoplasia, the relationship between vaginal microbiota and different grades of squamous intra-epithelial neoplasia is not well...

High risk genotype distribution of human papillomavirus (HPV) according to age groups in Iranian asymptomatic men

BackgroundThe Human Papillomavirus (HPV) is one of the most common sexually transmitted viruses worldwide. HPV infection in men is a serious clinical issue as they could be considered as a reservoir for inadvertently transmitting infection to women. Moreover, genital HPV infection could be a source for anogenital cancers in men.MethodsThis cross sectional study was conducted from January 2017 to December 2018. Four hundred fifteen asymptomatic men who were visited by specialists, referred to Nilou laboratory in terms of high risk (HR) HPV test testing. HR-HPV genotypes were detected using an approved assay which could discover HPV 16, HPV 18 and a pool of other high risk HPV genotypes as well as 16+ other HR and 18 + other HR (as multiple genotypes). SPSS software was used for statistical analysis.ResultsThe mean age was 33 ± 8.14 years. Specimens were referred to the laboratory by urologists, (n = 132, 32%, 95%CI: 25.0–39.4), dermatologists, (n = 104, 25, 95% CI: 19.1–30.9), gynecologists, (n = 75, 18, 95%CI: 13.3–29.3) and other specialists (n = 104, 25, 95% CI:19.1–30.9). The overall prevalence of other HR HPV, HPV16, HPV18 and multiple genotypes were 54.2% (45/83), 25.3% (21/83), 3.6% (3/83) and 16.8% (14/83), respectively. The frequency of HR-HPV, HPV16 and HPV18 genotypes was the highest among 30–40 years old.ConclusionThe prevalence of HR-HPV infection among Iranian asymptomatic males was relatively high. Investigation on HPV infection in men as reservoir and transmission vehicle of HPV in addition to screening in women will improve the national public health provisions and will contribute to the application of infection control measurements at a national level.

Mapping of fourteen high-risk human papillomavirus genotypes by molecular detection in sexually active women in the West African sub-region

The aim of this study was to determine the distribution of high-risk human papillomavirus genotypes (HR-HPV) in women from the general population of five West African countries. This was a cross-sectional descriptive study, involving 2133 women from nine cities of five West African countries: Benin, Burkina Faso, Cote d'Ivoire, Niger and Togo. Women were screened for precancerous cervical lesions and HR-HPV infection. The detection of HR-HPV was done by a multiplex real-time PCR on extracted viral DNA. The average age of the women in this study was 35.06 ± 10.00 years with a range of 15 to 65 years. The overall prevalence of high-risk HPV infection among general population sample of women in five West African countries was 33.61% (717/2133). The prevalence of dysplasia was 8.81%. In decreasing order of frequency, the genotypes found were: HPV 52 followed by HPV 31, 59, 51, 66, 45, 68, 56, 56, 58, 35, 39, 18, 33 and 16. The prevalence of HPV16/18 (bivalent vaccine types) was 7.02%. This study reveals a high prevalence of HPV 52 in West Africa. The extent and diversity of HR-HPV genotypes in these West African countries deserve special attention for prevention. Key words: High-risk HPV, real time PCR, genotypes, women, epidemiology, West Africa.

High-Risk Human Papillomaviruses in Oral Squamous Cell Carcinoma (OSCC): A Meta-Analysis

Background: The prevalence of high-risk Human Papillomaviruses (HPV) in cases of oral cavity squamous cell carcinoma (OSCC) varies widely. Therefore, the aim of this study was to determine the pooled prevalence of all high-risk HPV by meta-analysis with specific emphasis on HPV type 16/18. Methods: The studies were retrieved from PubMed and MEDLINE to conduct a comprehensive literature review on HPV detection in OSCC. Search terms included, High-risk HPV, oral cancer, polymerase chain reaction (PCR), in situ hybridization (ISH). We reviewed 47 research studies systematically to report the prevalence of high-risk HPV infection in oral cancer. Included studies published from 1988 to 2018. The meta-analysis was carried out by using MedCalc software version 19.0.3. Results: A meta-analysis was executed to calculate the pooled prevalence of High-risk HPV types, which revealed overall decreasing order frequency of high-risk HPV and high-risk type displaying the highest number of type16/18 HPV in the reported cases. As 30.71% [24.59 to 37.19 % confidence interval (CI) at 95%] and 28.88 % [22.62 to 35.57% confidence interval (CI) at 95%] followed by other high-risk HPV 3.59% [2.22 to 5.46%] respectively. Conclusions: According to present meta-analysis, we conclude that 16/18 HPV displaying maximum infection rate as compared to other high-risk HPV type in OSCC cases.

Detection of high-risk human papillomavirus (HPV) by the novel AmpFire isothermal HPV assay among pregnant women in Pemba Island, Tanzania.

Introductionhuman papillomavirus (HPV) is the most common sexually transmitted virus in the world. Prevalence of infection differs, with highest rates reported in sub-Saharan African, including the country of Tanzania. In pregnancy, the hormonal changes and immune changes seem to facilitate HPV persistence, increasing the cancer risk and the risk of vertical transmission towards the placenta and the fetus. The burden of HPV infection is still high despite multiple screening and detection test available. The AmpFire® HPV assay is a novel nucleic acid isothermal amplification with real-time fluorescence detection assay that can test simultaneously 15 high-risk HPV. This nested cohort study aims to contribute evidence on the prevalence of HPV infection and persistence across two time points among pregnant women in Pemba island, Tanzania.Methodsvaginal swabs that were previously collected during pregnancy were stored in eNAT buffer (n1=385 and n2=187) and were tested with AmpFire® screening assay, for simultaneous detection of the HPV 16, 18 and other high-risk HPV genotypes 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68.Resultsthe AmpFire® HPV assay detected an 11% and 6% high-risk HPV prevalence at the two time points among pregnant women in Pemba island, consecutively. For the 133 women whose samples were tested at both time points, the persistence rate of high-risk HPV was 64%.Conclusionnovel isothermal HPV assay, such as the AmpFire®, might be feasible to use in low-income regions.

Type-specific Distribution of Cervical hrHPV Infection and the Association with Cytological and Histological Results in a Large Population-based Cervical Cancer Screening Program: Baseline and 3-year Longitudinal Data.

Objectives: This study aimed to describe the study design, and to analyze the type-specific distribution of cervical high-risk human papillomavirus (hrHPV) infection and its association with cytological and histological results in a large population-based screening program in Buji Street, Shenzhen, China.Methods: A total of 10,186 women aged 21-70 years were co-tested by Cobas4800 HPV assay and liquid-based cytology. Women were referred to colposcopy by virtue of being HPV16/18-positive, Other hrHPV-positive/ cytology ≥ASCUS, or HPV-negative/ cytology ≥LSIL. Three-year histological follow-up data were recorded.Results: The overall prevalence of hrHPV infection was 11.1%; among them, the highest type was Other hrHPV (8.9%), followed by HPV16 (1.6%) and HPV18 (0.6%). Moreover, the prevalence of hrHPV and that of HPV16 increased with cytological severity (Ptrend <0.001). In the baseline phase, 106 women had cervical intraepithelial neoplasia 2/3 (CIN2/3) and six had cervical cancers. During 3-year follow-up, 12 cases of CIN2/3 and no cancers were identified. For HPV16-positive women with normal cytology, the baseline risks of CIN2/3 or worse (CIN2+/CIN3+) were 15.5% (7.0-23.9%) and 4.2% (1.4-8.5%) respectively. For Other hrHPV-positive women with normal cytology, the cumulative 3-year risks of CIN2+/CIN3+ were 3.1% (1.0-5.2%) and 0.7% (0.3-2.1%) respectively. Strikingly, 75.8% (322/425) of abnormal cytology and 50.9% (29/57) HSIL cytology were attributed to Other hrHPV infection in HPV-positive women. Similarly, Other hrHPV infection led to large proportions of CIN2 (62.7%) and CIN3+ (43.9%) over 3-year follow-up.Conclusions: The co-testing modality is a feasible, effective and safe option for cervical cancer screening in urban population. Great importance should also be attached to 'genotypes excluding HPV16/18' and separate detection of each genotype when considering screening and vaccination strategy.

Frequency and genotype distribution of high-risk human papilloma virus types in Karabuk province, Turkey: A hospital based cross-sectional study

Aim: In this cross-sectional study, we aimed to determine the prevalence and genotype distribution of high-risk human papillomavirus (HPV; HR-HPV) infection in patients admitted to the gynecology and obstetrics outpatient clinics of Karabuk University Training and Research Hospital.Material and Methods: A total of 402 women aged 18–65 years who were admitted to the gynecology and obstetrics Clinic, Karabuk University Training and Research Hospital, between October 2016 and June 2019 were included. The presence of HR-HPV and genotyping of HPV were investigated using real-time polymerase chain reaction in cervical swab samples.Results: HR-HPV infection was found in 23.9% of women. HR-HPV positivity was detected most commonly in the age group of 20–29 years. Regarding genotype distribution among HPV-positive women, the genotypes that included multiple HR-HPV infections (mixed HR-HPV) were the most common genotype (38.5%), followed by HPV-16 (13.1%) and HPV-52 (9.8%).Conclusion: Prevalence of HR-HPV infection was found to be high in our region, with the most commonly observed genotypes being those containing mixed HR-HPV. We believe that these results would be helpful during the selection of primary and secondary preventive measures for cervical cancer while planning vaccination and screening programs.

High risk HPV infection prevalence and associated cofactors: a population-based study in female ISSSTE beneficiaries attending the HPV screening and early detection of cervical cancer program

BackgroundCervical cancer is the second cause leading of malignancy-related death among Mexican women. The present study determined the population-based prevalence of high risk Human Papillomavirus (HR-HPV) infection and associated cofactors in female beneficiaries of the Institute of Security and Social Services for State Workers (ISSSTE) attending the Program for HPV Screening and Early Detection of Cervical Cancer and registered in the Women’s Cancer Detection System (SIDECAM).MethodsIn a cross-sectional study, cervical samples from 115,651 female users of the program for HPV screening and early detection of cervical cancer recruited in 23 ISSSTE care centers were analyzed for HR-HPV. Logistic regression analyses, adjusting for potential confounders, were performed to determine the association of HR-HPV infection with sexual health and behavior variables and with positivity to cervical premalignant lesions by cytology.ResultsThe overall prevalence of HR-HPV infection among female ISSSTE beneficiaries in the 2013–2015 period was 13%. A bivariate analysis of relevant variables for HR-HPV infection showed a statistically significant association for age, number of sexual partners, use of hormonal contraceptives and smoking. A statistical association was found between infection by HR-HPV with the use of hormonal contraceptives, number of sexual partners and smoking and association of HPV 16 and other non-16/18 HR-HPV infection with number of lifetime sexual partners and tobacco use adjusted for age, history of hormonal contraception, number of sexual partners and tobacco use with the exception of exposition variable itself. Similarly, an association was found between HR-HPV infection, regardless of the virus genotype, with positivity to cervical premalignant lesions adjusted for age, number of lifetime sexual partners, history of hormonal contraception and tobacco use.ConclusionsHR-HPV prevalence in female ISSSTE Women’s Cancer Program users is similar to the population-based prevalence previously reported in Mexican women without cervical alterations. The ISSSTE robust screening and early detection program, based on cytology studies and HPV co-testing, allows us to know the prevalence of HR-HPV infection among female users of the service.

High prevalence of high-risk human papillomavirus (HPV) infection among sexually active women in Ouagadougou.

Human papillomavirus (HPV) is the leading cause of cervical cancer, which in turn is the leading cause of cancer death in women in Africa. The objective of this study was to determine the prevalence of high-risk HPV infection (HR-HPV) and the distribution of genotypes encountered in the sexually active female population of Ouagadougou. In four level-two health centers, we recruited 234 women who agreed to undergo an endocervical swab. HR-HPV genotypes were identified by real-time PCR. The Chi-square test was used for comparisons, with significance defined by a P-value < 0.05. The prevalence of HR-HPV infection was 52.56%. Fourteen genotypes corresponding to 216 infections were characterized: HPV 59 (42/216), HPV 66 (30/216), HPV 56 (20/216), HPV 45 (20/216), HPV 58 (18/216), HPV 39 (18/216), HPV 51 (16/216), HPV 68 (14/216), HPV 52 (12/216), HPV 18 (12/216), HPV 35 (6/216), HPV 31 (5/216), HPV 16 (3/216), HPV 33 (0/216). HPV infection was statistically associated with age (P = 0.033) and with some specific sexual practices, such as oral sex (P = 0.001). The prevalence of HR-HPV infection among women without lesions in our study is higher than that reported previously in studies conducted in Ouagadougou among women in the general population and those found in the rest of the world. Moreover, HPV16 and 18 were not the genotypes most frequently encountered.

HPV genotype prevalence and distribution during 2009\u20132018 in Xinjiang, China: baseline surveys prior to mass HPV vaccination

BackgroundThe aim of this paper was to conduct a baseline survey of HPV infection in unvaccinated women in Xinjiang Uyghur Autonomous Region before the mass use of HPV vaccine.MethodsBetween 2008 and 2018, the HPV genotype detected by a PCR-based hybridization gene chip assay of 37,722 women who were from Gynecology Department and Health Management Center of the First Affiliated Hospital of Xinjiang Medical University were tested HPV genotype by a PCR-based hybridization gene chip assay. All statistical analysis methods were performed with this statistical software including Python version 3.6.1, R Software 3.5.1 and Excel 2011.ResultsThe total positive rate for HPV was 14.02%, the most prevalent genotypes were HPV 16 (3.79%), HPV 52 (2.47%), HPV 58 (1.76%), HPV 53 (1.35%) and HPV 31 (0.72%). The single infection (11.34%) and high-risk HPV (HR-HPV) infection (9.72%) was the main prevalence of HPV. Age-specific HPV distribution was presented as a bimodal curve, while the youngest age group (≤25 years) presented the highest HPV infection rate (20.78%), which was followed by a second peak for the 36–40 age group. According to the ethnic stratification, the HPV infection prevalence ranging from the high to low was: Mongol (16.36%), Hui (15.15%), Kazak (14.47%), Han (14.43%), Other (14.37%), Uygher (10.96%). From 2009 to 2013, the HPV infection rate fluctuated but did not changed much. It peaked in 2014 and then fell significantly, reached the bottom point in 2017 and rose slightly in 2018. In 2015, the infection rate of HPVl6 and 52 in the population was almost the same (both 3.40%) the infection rate of HPV52 type (3.31%) was higher than that of HPVl6 type (2.18%) and became the dominant type in 2016.ConclusionsWe present data regarding the prevalence and type distribution of HPV infection, which could serve as the valuable reference to guide nationwide cervical cancer screening. These baseline data enable the estimates of maximum HPV vaccine impact across time and provide critical reference measurements which are important to the assess of clinical benefits and potential harms in HPV vaccination and the increase in non-vaccine HPV types.

PI-1 Age-specific HPV prevalence among adolescent girls in Jos, North-Central Nigeria

Background: Knowledge of the age-specific prevalence of HPV types among adolescent girls in SSA is essential to determine the best age for introduction of HPV vaccination, monitoring of vaccine efficacy and provision of insight into persistent infection. Methods: We randomly selected 205 girls, age 9–20 years living in Jos, Nigeria. Informed consent and assent were obtained prior to training on self-collection of vulvo-vaginal samples using sterile swab stick and first void urine. HPV detection was carried out using HPV SPF10-DEIA/LiPA25. Data analysis was done using STATA14. Results: The mean (SD) age of the girls was 14.9 (2.3) years. AnyHPV was detected in 29.3% of participants. The earliest age at which anyHPV and high-risk HPV (hrHPV) infections were detected in either urine or vulvo-vaginal samples were 10 and 11 years of age respectively. The prevalence of anyHPV, hrHPV, lrHPV and multiple hrHPV peaked at 16 years of age. The prevalence of hrHPV infection was 3.4% among the 9–12 years age group, 7.8% among 13–16 years and 5.4% among 17–20 year old. The commonest hrHPV types detected were 52 (10.2%), 18 (6.3%) and 51 (4.4%). Conclusions: While a larger study is warranted, our findings suggest that in this population, HPV vaccination starting at 9 years of age would cover the at-risk population.

High-Risk Human Papillomavirus Infection and the Risk of Cardiovascular Disease in Korean Women.

Until now, no cohort studies have evaluated the relationship between high-risk human papillomavirus (HPV) infection and new-onset cardiovascular diseases (CVD). We investigated an association between high-risk HPV infection and the development of CVD. We conducted a cohort study of 63 411 women aged 30 or older without CVD at baseline who underwent a high-risk HPV test and were followed annually or biennially from 2011 to 2016. CVD was ascertained through the linkage to the Health Insurance and Review Agency database. A Cox-proportional hazards regression model was used to estimate adjusted hazard ratios (HRs) with 95% CIs of incident CVD. The prevalence of high-risk HPV infection was 7.6%. During 261 598.9 person-years of follow-up, 1122 cases of new-onset CVD were identified (incidence rate of 4.3 per 103 person-years). High-risk HPV infection was significantly associated with incident CVD. After adjustment for possible confounders, and high sensitivity C-reactive protein, a significant association between high-risk HPV infection and incident CVD was still observed, with a corresponding HR (95% CI) of 1.25 (1.03-1.52). This association was stronger among individuals with obesity and those with metabolic syndrome. Multivariable-adjusted HR (95% CI) for incident CVD comparing high-risk HPV-positive- to high-risk HPV-negative participants was 1.10 (0.87-1.39) in the nonobese, whereas corresponding HR (95% CI) was 1.73 (1.19-2.51) in those with obesity ( P for interaction by obesity=0.02). Similarly, multivariable-adjusted HR (95% CI) for incident CVD comparing high-risk HPV-positive- to high-risk HPV-negative participants was 1.09 (0.87-1.36) in those without metabolic syndrome and 1.99 (1.28-3.08) in those with MetS ( P for interaction=0.05). In this large cohort, high-risk HPV infection was significantly associated with an increased risk of developing CVD, especially in obese individuals and those with MetS, indicating that high-risk HPV might affect CVD risk with possible effect modification by obesity and MetS.

Distribution of high-risk human papillomavirus genotype prevalence and attribution to cervical precancerous lesions in rural North China.

ObjectivePrecise prevention is more desired for cervical cancer due to the huge population, high prevalence of human papillomavirus (HPV) infection in China and the vision of screen-and-treat strategies in low- and middle-income countries (LMICs). Considerations of combining type-specific prevalence and attribution proportion to high-grade cervical intraepithelial neoplasia are informative to more precise and effective region-specific cervical cancer prevention and control programs. The aim of the current study was to determine the genotype distribution of HPV and attribution to cervical precancerous lesions among women from rural areas in North China.MethodsA total of 9,526 women participated in the cervical cancer screening project in rural China. The samples of women who tested positive for HPV were retested with a polymerase chain reaction (PCR)-based HPV genotyping test. The attribution proportion of specific high-risk human papillomavirus (HR-HPV) types for different grades of cervical lesions was calculated by using the type contribution weighting method.ResultsA total of 22.2% (2,112/9,526) of women were HR-HPV positive and HPV52 (21.7%) was the most common HR-HPV genotype, followed by HPV58 (18.2%), HPV53 (18.2%) and HPV16 (16.2%). The top three genotypes detected in HR-HPV-positive cervical intraepithelial neoplasia (CIN)1 were HPV16 (36.7%), HPV58 (20.4%), HPV56 (15.3%). Among CIN2+, the most frequent genotypes were HPV16 (75.6%), HPV52 (17.8%), HPV58 (16.7%). HPV16, 56, 58, 53, 52, 59, 68, and 18 combined were attributed to 84.17% of all CIN1 lesions, and HPV16, 58, and 52 combined were attributed to 86.98% of all CIN2+ lesions.ConclusionsThe prevalence of HR-HPV infection among women from rural areas in North China was high and HPV16, HPV58, HPV52 had paramount attributable fraction in CIN2+. Type-specific HPV prevalence and attribution proportion to cervical precancerous lesions should be taken into consideration in the development of vaccines and strategy for screening in this population.

2509. High-Risk Human Papillomavirus Infection and the Risk of Cardiovascular Disease: A Cohort Study

BackgroundA study using National Health and Nutrition Examination Survey (NHANES) 2003 to 2006 demonstrated the association between high-risk (oncogenic) human papillomavirus (HPV) and an increased prevalence of the self-reported cardiovascular diseases (CVD). However, this study was limited by temporal ambiguity between HPV and CVD, because of its cross-sectional design. We investigated the longitudinal effect of HPV infection on the development of CVD events in a cohort study of Korean women free of CVD at baseline.MethodsWe conducted a cohort study of 63,411 women aged 30 or older without CVD at baseline who underwent a high-risk HPV test and were followed annually or biennially from 2011 to 2016 for new-onset CVD. CVD was ascertained through the linkage to the Health Insurance and Review Agency database. A Cox-proportional hazards regression model was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of incident CVD.ResultsThe prevalence of high-risk HPV infection was 7.6%. During 261,598.9 person-years of follow-up, 1,122 cases of new-onset CVD were identified (incidence rate of 4.3 per 103 person-years). The age-adjusted HR (95% CI) comparing high-risk HPV-positive- to high-risk HPV-negative participants was 1.26 (1.03–1.53). After further adjustment for possible confounders, a significant association between high-risk HPV infection and incident CVD was still observed, with a corresponding HR (95% CI) of 1.25 (1.03–1.53). This association was stronger in obese (BMI ≥25 kg/m2) compared with non-obese individuals (BMI <25 kg/m2). Otherwise, the associations between high-risk HPV infection and incident CVD did not differ by various clinically relevant subgroups.ConclusionIn this large cohort of apparently healthy young and middle-aged women, high-risk HPV infection was significantly associated with an increased risk of developing CVD, indicating a possible role for high-risk HPV in the pathogenesis of CVD.Disclosures All authors: No reported disclosures.

Oncogenic human papillomavirus infection and genotypes characterization among sexually active women in Tenkodogo at Burkina Faso, West Africa

ObjectiveThis study was conducted to determine the prevalence and distribution of high-risk human papillomavirus (HR-HPV) genotypes among sexually active women in Tenkodogo, Burkina Faso. MethodsAmong 131 sexually active women attending the Tenkodogo Urban Medical Center, endocervical samples were collected prior to screening for precancerous lesions. After viral DNA extraction, fourteen HR-HPV genotypes were characterized by real-time multiplex PCR in these cervical samples. ResultsThe mean age was 35.5 ± 9.5 years. Of the 131 women, 45 were infected with at least one HR-HPV genotype. The prevalence of HR-HPV infection among these women was 34.4%. Among the 45 oncogenic HPV-infected women, single HR-HPV genotype was found in 55.6% while 44.4% were infected with more than one HR-HPV genotype. The most frequent genotypes were HPV56 (36.5%), HPV66 (36.5%). ConclusionTenkodogo women included in this study had a higher prevalence of HPV 56, HPV 66. A larger study with a more representative sample would therefore be needed to determine predominant oncogenic genotypes in the subregion and especially in cancer cases.

Prevalence and type-specific distribution of human papillomavirus infection among women in mid-western rural, Nepal- A population-based study

BackgroundCervical cancer is the most common cancer among women in Nepal. The prevalence of human papillomavirus (HPV) 16 and or HPV 18 among women with cervical pre-cancer and cancer is higher than the incidence of HPV in the world population. The population-based epidemiological data of HPV in the general population in most parts of the country remains unknown. The objective of this study was to assess the prevalence and type distribution of HPV infection and association of abnormal cytology with high risk HPV infection among women in mid-western rural, Nepal.MethodsA population-based cross sectional study was conducted in Jumla, one of the most remote districts in Nepal. A total of 1050 cervical samples were collected from married and non- pregnant women aged 20–65 years during mobile Cervical Cancer Screening Clinics conducted from May 2016 to January 2017. The presence of HPV DNA was firstly confirmed by HPV consensus PCR using PGMY09/PGMY11 designed primers, then HPV positive samples were further genotyped by the membrane hybridization method to detect the 21 high-risk HPV (HR-HPV) and low-risk HPV types. The prevalence of HR-HPV among women with normal and abnormal cytology was calculated. Data were analyzed using SPSS software for Windows. P < 0.05 was considered statistically significant.ResultsA total of 998 women were eligible for this study with the mean age 32.6 ± 8.6 years, and the mean marital age was 16.7 ± 3.8 years. The overall prevalence of HPV infections was 19.7%. HR-HPV and low-risk HPV were 11.7 and 8.7% respectively. The six most common HR-HPV types were HPV16, 39, 58, 33, 51 and 18. HR-HPV infection among the women with abnormal and normal cytology was of 27.3 and 10.8% respectively.ConclusionsThere was a higher prevalence of HR-HPV infection among women living in Jumla than other parts of Nepal. This study provides preliminary information on overall HPV and type-specific HR-HPV prevalence, HR-HPV 16, 39, 58, 33, 51, and 18 are the most prevalent genotypes in this region. The data contribute to the epidemiological knowledge about HPV and type-specific HR-HPV genotypes prevalence in mid-Western Nepal.

National point prevalence survey of human papillomavirus infections in Tunisia, 2012–2014: Genotypes and risk factors

Background Persistent infection with high-risk Human Papillomavirus (HPV) genotypes may, without treatment, progress to invasive cervical cancer, the second gynecological cancer in Tunisia. This study aims to determine the prevalence of HPV infections, to identify risk factors and main circulating genotypes. Methods National point prevalence survey, between December 2012 and December 2014. Were eligible for inclusion, women aged 18 to 65 years, sexually active, who sought medical attention at their primary health care centre or clinic, the day of the survey, and who gave written consent. Women having an abnormal genital bleeding or a visible lesion in the cervix were not included. A standardized questionnaire on sociodemographic and behavioral factors was orally administered. A liquid-based Pap smear sample was obtained from included women using a cervical brush. If betaglobin positive, samples were analyzed for HPV detection and typing. Multiple logistic regression modeling was done using SPSS 20. Results Out of 1518 women included in the survey with mean age 40.4 ± 0.9 years, 1229 were betaglobin positive. The national prevalence of HPV infection was 7.8% (95% CI [3.4–14.4%]). In multivariate analysis, factors associated to HPV infection were having multiple sexual partners (ORa = 5.2; 95% CI [2.2–11.6]), smoking (ORa = 4.7; 95% CI [2.2–9.8]) and medical history of sexually transmitted infection (ORa = 1.9; 95% CI [1.2–3.1]). Twenty different genotypes of HPV were identified, the most common were HPV6 (25.4%; 95% CI [16.9–36.9%]) and HPV16 (14.1%; 95% CI [16.9–36.9%]). Conclusions T This first national prevalence survey of HPV infection in Tunisia provides important insight into associated factors and main circulating genotypes to improve cervical screening. Next step is a cost-effectiveness analysis of a national HPV immunization programme.

Prevalence of human papilloma virus infections among women with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is considered one of the risk factors for cervical cytological abnormalities and high-risk HPV infection. However, there is a scarcity of data about the prevalence of high-risk HPV infection in patients with lupus. In order to define strategies for cancer prevention, we aimed to determine the prevalence of HPV infections in women with SLE compared to a control group. Fifty patients with SLE from the SLE clinic in Hafez Hospital, Shiraz University of Medical Sciences, were compared to 50 healthy married control women. In both groups, routine Pap smears were obtained, and the endocervical side of the spatula was sent for HPV DNA analysis. The case and control groups were compared for the presence and type of HPV infection as well as the relation between its presence with immunosuppressant use and disease activity. HPV infection was detected in 4% (2.50) of lupus patients, but it was not seen in the control group. HPV typing identified types 16 and 18 in these two patients. No relationship between HPV infection and immunosuppressant use or activity of disease was seen in the current study. There was no statistically significant difference in HPV prevalence between patients and the control group (P=0.495). Results of this study showed that SLE and the use of immunosuppressants in patients with lupus were not risks for high-risk HPV infection or cervical dysplasia in our area compared to the normal population, but further studies on more patients receiving immunosuppressants and biologics are recommended.

Association between visual inspection of the cervix with acetic acid examination and high-risk human papillomavirus infection, Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in Papua New Guinea.

Papua New Guinea (PNG) has among the highest estimated burdens of cervical cancer globally but currently has no national cervical screening program. Visual inspection of the cervix with acetic acid (VIA) is a low-cost screening strategy endorsed by the World Health Organization that has been adopted in many low-resource settings but not previously evaluated in PNG. To evaluate the association between VIA examination findings and high-risk HPV (hrHPV) infection; and the impact of concomitant genital Chlamydiatrachomatis, Neisseriagonorrhoeae and Trichomonasvaginalis on the interpretation of VIA findings. A prospective clinical cohort study among women aged 30-59years attending Well Woman Clinics in PNG. Main outcome measures were VIA examination findings and laboratory-confirmed hrHPV, C.trachomatis, N.gonorrhoeae and T.vaginalis. A total of 614 women were enrolled, of whom 87.5% (537/614) underwent VIA, and 12.5% (77/614) did not due to pre-existing cervicitis or inability to visualise the transformation zone. Among the 537 women who underwent VIA, 21.6% were VIA positive, 63.7% VIA negative, and 14.7% had indeterminate findings. The prevalence of hrHPV infection (n=614) was 14.7%; C.trachomatis, 7.5%; N.gonorrhoeae, 8.0%; and T.vaginalis, 15.0%. VIA positive women were more likely to have HPV16 (odds ratio: 5.0; 95%CI: 1.6-15.6; P=0.006) but there was no association between HPV18/45, all hrHPV types (combined), C.trachomatis, N.gonorrhoeae or T.vaginalis. VIA positivity was associated with HPV16, but not with other hrHPV infections, nor with genital C.trachomatis, N.gonorrhoeae or T.vaginalis in this setting.