Risk Factors For HPV Infection Research Articles

Analysis of multi-site HPV infection and vaccination willingness among men who have sex with men in Tianjin, China.

Men who have sex with men (MSM) are vulnerable to HPV infection. This study aims to explore the HPV infection status at different sites among HIV-positive MSM, HIV-negative MSM, and men who have sex with women (MSW), and to investigate their willingness to receive HPV vaccination. From September 2023 to April 2024, three groups were recruited in Tianjin, China. Participants completed an electronic self-administered questionnaire, which included demographic information, knowledge related to sexually transmitted diseases, behavioral information, and willingness to receive the HPV vaccine. Samples were collected from the anal region, genitals, and oral cavity for HPV typing. A total of 1,559 participants were recruited, including 300 HIV-positive MSM, 600 HIV-negative MSM, and 659 MSW. The HPV infection prevalence for any site were 62.0, 53.7 and 8.3%, respectively (p < 0.001). The infection prevalence for HPV genes covered by the 9-valent vaccine were 47.0, 36.8, and 3.5%, respectively (p < 0.001). Co-infection prevalence at anal and genital were 20.3, 14.2, 0.6%, respectively. Co-infection prevalence at anal and genital and oral were 1.3, 0.3%, 0, respectively. A total of 77.0% HIV-positive MSM and 75.3% HIV-negative MSM expressed willingness to receive the HPV vaccine, whereas 58.9% of MSW were unwilling (p < 0.001). Being HIV-positive (aOR, 3.119; 95% CI, 2.213-4.395), being over 46 years old (aOR, 1.994; 95% CI, 1.266-3.142), with an occupation classified as "white collar workers" (aOR, 1.620; 95% CI, 1.111-2.362) and "freelancing" (aOR, 2.025; 95% CI, 1.371-2.993) and a history of homosexual behavior in the past 6 months (aOR, 5.338; 95% CI, 3.802-7.495) were risk factors for HPV infection among men in Tianjin. Consistently using condoms in the past 6 months (aOR, 0.667; 95% CI, 0.513-0.867) were protective factors. The HPV infection prevalence among MSM in Tianjin is significantly higher than among MSW, with higher prevalence in the anal region compared to the genital and oral region. HPV infection is associated with HIV infection, older age, and homosexual behavior. Most MSM showed a positive willingness to receive the HPV vaccine, indicating the necessity to implement targeted HPV vaccination programs for MSM and to enhance necessary preventive knowledge and behavioral interventions.

Awareness of HPV and HPV vaccine among college students in China.

Cervical cancer is the fourth most common cancer among women, HPV vaccine can reduce the incidence of cervical cancer by approximately 70%. Sexual behavior is a direct risk factor for HPV infection, and sexually active college students, therefore, receive attention for HPV vaccination. This study aimed to investigate the awareness of HPV and its vaccine among college students in Zhengzhou, and to explore the factors influencing their awareness of HPV vaccine, to understand college students' willingness to receive the vaccine. The findings of this study will lay a foundation for cervical cancer prevention. Using a multistage random sampling method, 650 college students from four universities in Zhengzhou were selected. A self-administered questionnaire on the awareness of HPV and its vaccine, and willingness to receive HPV vaccination was carried out. Logistic regression was used to analyze the factors influencing students' awareness of the HPV vaccine. 58.0% of college students had heard of HPV, and 72.8% of college students had heard of HPV vaccine. Logistic regression showed that gender, major, grade, mean monthly consumption level, sexual history, and mother cervical cancer screening participation significantly influenced the awareness of HPV vaccine (p < 0.05). Only 27(4.2%) college students had received the HPV vaccine. 63.2% of college students expressed their willingness to get vaccinated. The awareness of HPV and its vaccine among college students in Zhengzhou needs improvement. Although the vaccination rate is low, most college students are willing to be vaccinated. Diverse health education programs should be conducted for different groups to improve awareness of cervical cancer prevention and promote vaccination.

HPV vaccine behaviors and intentions among a diverse sample of women aged 27-45 years: implications for shared clinical decision-making

BackgroundThe Advisory Committee on Immunization Practices issued a shared clinical decision-making (SCDM) recommendation for HPV vaccination in persons aged 27–45. Since expanded eligibility for the vaccine was issued, little information has been available about HPV vaccine behaviors and intentions among women in this age group.MethodsWe conducted a cross-sectional online survey among women aged 27–45 years recruited through a Qualtrics™ respondent panel (N = 324) to answer the following questions (1) What is the prevalence of HPV vaccination among a diverse sample of adult women aged 27–45 years? (2) What are the characteristics of those who have or have not previously been vaccinated? and (3) What factors are associated with the intention to obtain the HPV vaccine among those who had never been vaccinated? Multivariable logistic regression analyses estimated adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs).ResultsOnly 31.1% had at least one dose of the HPV vaccine. In multivariable analyses, those more likely to have been vaccinated were younger and were more likely to believe that the vaccine was effective. Of those unvaccinated or unsure, 54.8% indicated they were likely to get vaccinated in the future. Factors associated with future vaccine intention (compared to those not intending) included beliefs about vaccine testing, perceived likelihood of HPV infection, greater comfort in asking one’s provider for vaccination, and prior negative healthcare experiences.ConclusionsOur findings suggest that many women in this age group are interested in HPV vaccination. While the recommendation is for SCDM rather than routine vaccination for all women in this age group, efforts to promote informed decision-making among mid-adult women may include educating women about the rigorous vaccine testing and approval process, their risk factors for HPV infection, and encouraging them to engage in SCDM with their medical providers. Targeted efforts to reach women who have had negative experiences with healthcare may also be needed.

Analysis of risk factors associated with cervical HPV infection and their effects on female sexual function and anxiety: a multicenter cross-sectional study based on Chinese women.

This research aimed to explore the determinants of cervical HPV infection and evaluate how cervical cancer screening outcomes influence sexual functioning and anxiety among women across three provinces in China. Study participants were categorized into HPV-positive or HPV-negative groups, after which they completed the General Characteristics Questionnaire and the SAS Anxiety Scale. The HPV-positive cohort was further divided into four subgroups: Subgroup 1 consisted of individuals with HPV types 16 or 18 but no cytological abnormalities. Subgroup 2 included those with cytological abnormalities and infections with HPV types 16 or 18. Subgroup 3 included participants infected with high-risk HPV types other than 16 and 18, who did not show cytological abnormalities, while Subgroup 4 encompassed individuals with both cytological abnormalities and infections with high-risk HPV types other than 16 and 18. All participants were assessed using the Female Sexual Function Index Scale (FSFI), which measures sexual function across these subgroups. A total of 531 questionnaires were analyzed. Logistic regression identified several risk factors for HPV infection, including manual labor, service occupations, other occupations, low- and middle-income groups, and cervical columnar epithelial ectasia, as well as an increase in the number of previous sexual partners. Conversely, protective factors included condom use during sexual activity and mutual genital hygiene prior to intercourse. The incidence of lower genital tract infections was significantly higher in the HPV-positive group compared to the HPV-negative group, with rates of chlamydia (13.3% versus 4.6%, P<0.001), gonococcal infections (5.2% versus 0.4%, P<0.001), and mycobacterial diseases (38.9% versus 23.4%, P<0.001). Additionally, anxiety levels were significantly higher in the HPVpositive group compared to the HPV-negative group (p<0.005). Anxiety levels and cytological outcomes were significantly correlated across the four HPV-positive subgroups (p<0.05), with type 16/18 infections being associated with notably lower FSFI scores compared to other high-risk HPV types (p<0.05). The findings suggest that infections with HPV type 16/18, especially when accompanied by abnormal cytological findings,significantly elevate anxiety and distress in women and are associated with reduced FSFI scores. These results highlight the complex impact of HPV infection on women's sexual health and psychological well-being with HPV type 16/.

Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China

BackgroundThe incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women.MethodsA longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years.ResultsThe HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively).ConclusionsOur results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.

Correlation between vaginal flora and cervical immune function of human papilloma virus-infected patients with cervical cancer.

To analyse the correlation between vaginal flora and cervical immune function of HPV-infected patients with cervical cancer. Six hundred females with genital tract infections treated in Xuzhou Hospital of Traditional Chinese Medicine from January 2014 to December 2016 were selected and divided into a high-risk HPV group (n=246) and a control group (n=354). The vaginal flora and human T lymphocyte subsets (CD3+, CD4+, CD8+) were detected. Multivariate logistic regression analysis was performed to explore the risk factors for HPV infection. The numbers of CD4+ and CD4+/CD8+ T cells of the high-risk HPV group were significantly lower than those of the control group (P<0.05). The two groups had similar numbers of CD3+ and CD8+ T cells. In the high-risk HPV group, the positive rates of Lactobacillus, Chlamydia trachomatis, Mycoplasma hominis, mycetes, Ureaplasma urealyticum and bacterial vaginosis were significantly higher than those of the control group (P<0.05). There was no significant difference in the positive rates of trichomonads between the two groups. Multivariate logistic regression analysis revealed that C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection (P<0.05). High-risk HPV infection in patients with cervical cancer was associated with vaginal flora and immune function. C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection.

Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria.

BackgroundThere are limited data on the epidemiology of HPV in different anatomical sites of female sex workers (FSW). We investigated the prevalence and concordance of cervical, vulval, oral and anal HPV among FSW in Ibadan, Nigeria.MethodsFSWs aged 18–45 years were enrolled in a cross-sectional survey. After interview and clinical examination, samples were collected from mouth, cervix, vulva and anus. HPV genotyping was done with Anyplex II 28HPV assay. Multivariable analyses were performed to explore associated risk factors and concordance of HPV infections across sites.ResultsIn total, 315 FSWs participated in the study with a mean age of 30–6.5 years. The prevalence of any HPV infection was 88% in the vulva, 84% in the cervix, 75% in the anus and 24% in the oral cavity. HPV 35 was the most prevalent and concordant high-risk type in the four sites. The risk factors for HPV infection by anatomic site varied.ConclusionThis large study showed a high prevalence and concordance of HPV infections of cervical, vulval, oral and anal HPV among FSWs in Nigeria. The potential to acquire and transmit HPV is high in this population, and we highlighted the urgency to protect young women through HPV vaccination.

Evaluation of Awareness of Human Papillomavirus and Cervical Cancer among Female Undergraduates of a Private Mission University in Southwestern Nigeria

Background: Human papillomavirus infection is most prevalent in the younger population and causes cervical cancer, which is the leading cause of cancer death worldwide. In 2018, cervical cancer was estimated to be 570,000 cases and 311,000 deaths; it ranked as the fourth most commonly diagnosed cancer and the fourth leading cause of cancer death in women. Cervical cancer can be prevented through health education and vaccination against HPV. This study aimed at evaluating the level of awareness of human papillomavirus and cervical cancer among female undergraduate students of Babcock University, Ogun state of Nigeria. Methodology: This was a cross-sectional, questionnaire-based study conducted among 310 female undergraduates of Babcock University in Nigeria from January to April 2019. The selection technique was a multistage random sampling method. The data collection was done using structured and self-administered questionnaires. Data collected were analyzed using IBM Statistical Package for Social Sciences (SPSS) statistics for windows version 25 and were presented in summary charts and frequency tables. P-values less than or equal to 0.05 were considered statistically significant. Results: Of 310 female students, 296 (95.5%) were aware of HPV infections. The majority, 215 (69.4%) of the students knew that HPV is sexually transmitted. There was poor knowledge of the risk factors of HPV infection. Only, 65 (21.0%) were aware that HPV infection causes cervical cancer. A few proportions of students 79 (25.4%) were aware of the HPV vaccine. Consequently, only 44 (14.2%) have received HPV vaccination and some complained about the cost as a significant reason for not being vaccinated against HPV infection. Conclusion: The level of awareness of HPV infection,

Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study

BackgroundHuman Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women.MethodWomen presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05.ResultsThe age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016).ConclusionsOur study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.

Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women

BackgroundHuman papillomavirus (HPV) associated cancers are increasingly reported globally, including in sub-Saharan Africa (SSA). However, with the exception of cervical HPV infection, data from SSA on the epidemiology of oral and genital HPV infections are limited. This study assessed the prevalence and concordance of oro-genital and anal HPV genotype specific infections among women in the general population.MethodsWe conducted a cross-sectional study in sexually active women aged 18–45 years in Ibadan, Nigeria. After a face-to-face interview and clinical examination, oral, cervical, vulvar, and anal samples were collected from participants and tested by the Anyplex II 28 HPV assay. Descriptive and multivariable analyses were used to report prevalence and risk factors associated with HPV infections.ResultsThe prevalence of any vulva, cervical, anal, and oral HPV infections was 68.0% (210/309), 59.7% (182/305), 56.8% (172/303), and 16.1% (14/286), respectively. There was an inverse relationship between age-group and HPV prevalence of HPV in all anatomic sites except for the oral HPV infections. HPV 35 was the most prevalent high-risk HPV genotype in the vulva, cervix and oral cavity. Associated risk factors for HPV infection in each of the anatomic sites were reported. Overall, 10.0% (31/310) women had concordance of any HPV type in the four anatomic sites.ConclusionThere was a high prevalence of oro-genital and anal HPV infections among sexually active Nigerian women, with concordance of HPV types in the cervix, vulva, anus and oral cavity. We advocate large longitudinal studies that will involve sampling of multiple anatomic sites and inclusion of other women in the community for better understanding of HPV epidemiology in this region.

The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

This cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women

In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20–41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8–316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.

RISK OF ANAL CANCER IN INFLAMMATORY BOWEL DISEASE PATIENTS IN THE US: A POPULATION-BASED STUDY 2008–2018

Abstract Background Patients with inflammatory bowel disease (IBD) are at elevated risk of developing anal cancer. However, it remains unclear whether the increased risk manifests from immunosuppressant use or location of the disease (inflammation). We aimed to examine whether the risk of anal cancer in IBD patients is attributable to immunosuppression or the disease’s location by comparing IBD patients with rheumatoid arthritis (RA) and diverticulitis patients, respectively. Methods We conducted a retrospective cohort study using the US Optum® commercial claims database (2008–2018). We estimated the risk of anal cancer in the IBD cohort compared to the RA cohort (to examine risk attributable to immunosuppressant use) and the diverticulitis cohort (to examine risk attributable to similar disease location). Disease cohorts and index dates were identified using a combination of ICD diagnosis codes and prescription drug use. Patients 18 years and older and with a minimum of 12 months of continuous insurance enrollment were included. All three cohorts were mutually exclusive; we excluded persons with HIV/AIDS or organ transplant. We estimated hazard ratios (HRs) using Cox proportional regression, adjusting for age at diagnosis, comorbidity, risk factors for HPV infection (smoking, obesity, genital wart, substance abuse, alcoholism), and prescription drug use. Analyses were stratified by sex. Results The study included 70,314 patients with IBD, 164,991 with RA, and 129,558 with diverticulitis. In men, the adjusted hazard ratio (aHR) of developing anal cancer was 6.78 (95% CI, 3.40–13.55) comparing IBD to RA, and was 2.68 (95% CI, 0.99–7.30) comparing IBD to diverticulitis. Among women, the risk of developing anal cancer was significantly higher in IBD compared to RA (aHR 2.70; 95% CI, 1.36–5.35), but not different compared to diverticulitis (aHR 0.70; 95% CI, 0.20–2.44). The factors associated with a higher risk of anal cancer in both men and women were age at diagnosis, history of genital wart, corticosteroid use, and immunosuppressant use. Conclusion We found a significantly elevated risk of anal cancer in IBD patients than RA patients. However, anal cancer risk was not significantly different when comparing IBD patients to diverticulitis patients. These results indicate that the location of the disease is more strongly associated with anal cancer incidence than the treatment of autoimmune disease.

Genotype Distribution and Prevalence of High-Risk Human Papillomavirus Based on 20,103 Self-Collected Samples From 13 Regions of China

Objective: To investigate the epidemiological characteristics of high-risk human papillomavirus (HR-HPV) infection and the genotype distribution of HR-HPV in different regions of China using self-collected vaginal samples. Study Design and Setting: A total of 20,136 women aged 30–59 years were recruited from 13 provinces in China from September 2018 to July 2020. All participants registered, signed electronic informed consent, and filled in individual information voluntarily using an internet-based cervical cancer screening platform, then received a self-sampling kit. The samples were tested for 14 types of HR-HPV using the SeqHPV and BMRT HPV PCR assays. Results: After excluding 33 samples because of labeling errors or insufficient amounts of HPV DNA in specimens, 20,103 women (99.84%) were ultimately analyzed with a mean age of 44.31 ± 7.70 years. The overall prevalence of HR-HPV infection was 13.86%. The vast majority of HR-HPV (77.18%) were still a single type. Among 13 regions, Inner Mongolia had the highest prevalence (21.55%), while the lowest prevalence was in Jilin (9.51%). The following factors were found to be significantly associated with HR-HPV infection: age, sexual behavior, irregular screening, and economic level. The top five most common HR-HPV subtypes were HPV-52 (3.42%), HPV-58 (2.29%), HPV-16 (2.17%), HPV-39 (1.35%), and HPV-51 (1.30%), while HPV18 (0.86%) was the less prevalent. The prevalence of infection with a single type of HR-HPV was 10.70% and the prevalence of infection with multiple types was 3.16%. The prevalence curve of age-specific HR-HPV was V-shaped from 30 years to 59 years, with a lower prevalence observed in women aged 40–44 years (12.35%) and infection subsequently increasing with age. The proportion of women aged 30–34 years with HPV-16 (17%) was much higher than the proportion in other age groups, and the prevalence of HPV-18 (6%) was highest in women aged 45–49 years. The undeveloped regions (according to the GDP) had the highest prevalence of specific combinations of HR-HPV subtypes, of which HPV-16/HPV-18 infections decreased with increasing GDP. Furthermore, a more number of sexual partners and age of first sexual intercourse <20 years were risk factors for HPV infection, whereas education and barrier contraception were protective factors. Conclusion: The prevalence, genotype distribution, epidemiological characteristics and influencing factors of HR-HPV infection based on self-sampling varied in different regions of China. It is therefore crucial to develop specific plans for cervical cancer screening in different regions. Using the Internet for self-sample screening way could a much greater increase the coverage of cervical cancer screening. Clinical Trial Registration Details: Chinese Clinical Trial Website (https://www.chictr.org.cn, ChiCTR2000032331). Funding Information: The study was supported by Association for Maternal and Child Health Studies (No. 2018AMCHS00801); the National Key Research and Development Program of China (No. 2016 YFC1302901). Declaration of Interests: None. Ethics Approval Statement: The study was approved by the Ethics Committee of the Peking University People’s Hospital (2018PHB056-01) in Beijing, China.

Prevalence and correlation of human papillomavirus genotypes with clinical factors in cervical samples from Mexican women.

We are submitting data regarding the prevalence and type distribution of the HPV infection and the risk factors associated with it, which may provide a valuable reference to reinforce screening strategies, and to maintain HPV genotype surveillance in Mexico. We discuss the overall prevalence of HPV infection as detected in normal cytological samples stratified by age, different types of infection, and oncogenic capacity. One of the most important findings was that common HPV genotypes detected in healthy women were the genotype numbers: 6, 31, 16, and 56, likewise, smoking and having a history of more than three sexual partners over their lifetime, represented the main risk factors in this study. Furthermore, we found a low frequency of cytological abnormalities and CIN 1-3 in women with HR-HPV.

Knowledge and Awareness Regarding HPV Infection and Pap Smear Screening in Reproductive Aged Females in Delhi NCR Rural Region

The purpose of the study was to document the knowledge and awareness of HPV infection and Pap smear among the study women and to conduct screening with Pap smear cytology and HPV testing. The study also aimed to further perform a correlation analysis of HPV prevalence with demographic data. The present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health centre. Majority of the study participants were young married ladies and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. The study reported a high prevalence of HPV infection in rural women attending the gynaecology and cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Knowledge and awareness regarding HPV infection and PAP smear screening in reproductive aged females of rural India

PurposeThe purpose of the study was to document the knowledge and awareness of HPV infection and Pap smear among the study women and to conduct screening with Pap smear cytology and HPV testing. The study also aimed to further perform a correlation analyses of HPV prevalence with demographic data. MethodsThe present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health center. ResultsMajority of the study participants were young married ladies and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. ConclusionThe study reported a high prevalence of HPV infection in rural women attending the Gynaecology and Cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Prevalence of HPV infection in reproductive aged female in Delhi NCR region

PurposeThe purpose of the study was to conduct screening with Pap smear cytology and HPV testing among study women. The study also aimed to further perform a correlation analyses of HPV prevalence with demographic data. MethodsThe present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health center. ResultsMajority of the study participants were young married women and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. ConclusionThe study reported a high prevalence of HPV infection in rural women attending the Gynaecology and Cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Prevalence and genotype-specific distribution of human papillomavirus in Burundi according to HIV status and urban or rural residence and its implications for control.

BackgroundHuman papillomaviruses are the most important causative agents for invasive cervical cancer development. HPV type-specific vaccination and HPV cervical cancer screening methods are being widely recommended to control the disease but the epidemiology of the circulating HPV types may vary locally. The circulating HPV-strains have never been assessed in Burundi. This study determined the prevalence and genotype-specific distribution of HPV in four different strata in Burundi: HIV-infected or non-infected and women living in rural or urban areas. Implications for HPV diagnosis and vaccine implementation was discussed.MethodsFour cross-sectional surveys were conducted in Burundi (2013 in a rural area and 2016 in urban area) among HIV-infected and uninfected women living in rural and urban areas. Liquid-Based Cytology (LBC) and HPV genotyping were performed and risk factors for HPV infection and cervical pre-cancer lesions were determined using logistic regression model.ResultsHPV prevalence was very high in urban area with significant differences between HIV-positive and negative women (p<0.0001). In fact, 45.7% of HIV-positive participants were infected with any HPV type and all were infected with at least one HR/pHR-HPV type. Among the HIV-negative participants, 13.4% were HPV-infected, of whom, only four women (2.7%) were infected with HR/pHR-HPV types. In rural area, HPV infection did not significantly differ between HIV-positive and negative women (30.0% and 31.3% respectively; p = 0.80). In urban area, multiple infections with HR/pHR-HPV types were detected in 13.9% and 2.7% among HIV-positive and negative women respectively (p<0.0001), whereas in rural area, multiple infections with HR/pHR-HPV types were detected in 4.7% and 3.3% of HIV-positive and negative women respectively (p = 0.56). The most prevalent HR/pHR-HPV types in HIV-positive women living in urban area were HPV 52, 51, 56, 18 and 16 types. In HIV-negative women living in urban area, the most prevalent HR/pHR-HPV types were HPV 66, 67, 18, 45 and 39 types. In HIV-positive women living in rural area, the most prevalent HR/pHR-HPV types were HPV 66, 16, 18 and 33 types. In HIV-negative women living in rural area, the most prevalent HR/pHR-HPV types were HPV 16, 66, 18, 35 and 45 types. Independent risk factors associated with cervical lesions were HPV and HIV infections.ConclusionsThere is a high burden of HR and pHR-HPV infections, in particular among HIV-infected women living in urban area. The study points out the need to introduce a comprehensive cervical cancer control programme adapted to the context. This study shows that the nonavalent vaccine covers most of the HR/pHR-HPV infections in rural and urban areas among HIV-infected and uninfected women.

Serum Se, Ni, and As are associated with HPV infection and CIN2+ among Uyghur women in rural China

BackgroundCervical cancer incidence and mortality is high in Uyghur ethnics. Their life style and dietary habit were different from other ethnics living together. Study on the role of trace elements in HPV infection and cervical lesion of Uyghur minority is needed for future intervention and prevention work.MethodsIn total, 833 Uyghur women were randomly selected from the screening site and hospital. The concentrations of the trace elements As, Fe, Cd, Ni, Cu, Zn, Mn, and Se were determined by atomic absorption spectrophotometry and inductively coupled plasma atomic emission spectroscopy. Univariate analysis was performed with chi-squared test between the HPV-positive and HPV-negative groups and between the case group and the control group. Multivariate analysis was performed with logistic regression.ResultsAn As concentration ≥ 0.02 mg/kg was a risk factor for HPV infection (OR > 1, P < 0.05), and Ni concentration ≥ 0.1232 mg/kg and Se concentration ≥ 0.02 mg/kg were protective factors (OR < 1, P < 0.05). Concentrations of Fe ≥ 6.9153 mmol/L and As ≥0.02 mg/kg were risk factors for CIN2+ (OR > 1, P < 0.05), and concentrations of Ni ≥0.0965 mg/kg and Se ≥0.02 mg/kg were protective factors (OR < 1, P < 0.05).ConclusionsLow serum concentrations of Se and Ni and a high serum concentration of As might be related to HPV infection and CIN2+ in Uyghur women in rural China.