Human Papillomavirus Risk Factors Research Articles

Risk factors for anal human papillomavirus infection type 16 among HIV-positive men who have sex with men in San Francisco.

HIV-positive men who have sex with men (MSM) are at high risk of anal cancer compared with the general population. Human papillomavirus (HPV) infection, particularly HPV 16, is causally associated with anal cancer. However, the risk factors for anal HPV 16 infection are poorly understood. We determined the prevalence and risk factors for anal HPV 16 infection in a population of HIV-positive MSM, most of whom were being treated with antiretroviral therapy. Cross-sectional data from the baseline visit of a 4-year prospective cohort study. Three hundred forty-eight HIV-positive MSM were recruited in San Francisco, and they received a detailed sexual behavior risk factor questionnaire. An anal swab was used to collect specimens for HPV type-specific DNA testing using L1 HPV DNA polymerase chain reaction. We used log-binomial multivariable models to determine the risk factors for anal HPV 16 infection. Ninety-two percent of HIV-positive MSM had at least 1 anal HPV type, 80% had at least 1 oncogenic HPV type, and 42% had HPV 16. Non-Hispanic white race and higher level of education were associated with a decreased risk of HPV 16 infection. A higher number of total male partners was associated with HPV 16 (relative risk: 1.6, 95% confidence interval 1.1 to 2.4, P = 0.01) for 201-1000 partners compared with 1-200. Injection drug use was independently associated with anal HPV 16 infection (relative risk: 1.5, 95% confidence interval 1.2 to 1.9, P = 0.003). The prevalence of anal HPV infection, including HPV 16, is high in HIV-positive MSM. HIV-positive MSM should be counseled about the risk associated with increased partners and injection drug use.

Risk factors for human papillomavirus infection in Shanghai suburbs: A population-based study with 10,000 women

BackgroundHigh risk human papillomavirus (HPV) infection is the major cause of cervical cancer. Several epidemiological studies have performed HPV screening in Chinese women, but no report was for Shanghai suburb women. ObjectivesTo understand the prevalence of HPV infection and risk factors in Shanghai suburbs. Study designBetween March 2011 and May 2011, 10,000 female volunteers lived in Fengxian District of Shanghai were recruited for the detection of 21 HPV types using PCR and fast flow hybridization of gene chip array. For the 508 HPV-positive patients, we performed the liquid-based ThinPrep cytology test (TCT) and histological examination for the diagnosis of local cervical lesions. The questionnaire surveyed demographic and behavioral indicators for the evaluation of risk factors of HPV infection. ResultsWe found that the HPV-positive rate was 12.6%. The five top HPV types were as follows (in descending order): HPV52, 16, 58, 18 and 33. Moreover, HPV-positive rates were higher in women with older age, lower educational level, younger age of the first sexual intercourse, multiple sexual partners, no usage of condom for contraception, multiple deliveries, vaginal delivery, menopause, vaginal inflammation, cervical erosion and no regular cervical cytological examination. We also found that an HPV genotyping in combination with TCT and histological examination could improve early diagnosis for local cervical lesions. ConclusionHPV infection was associated with age, sexual behavior and chronic inflammation of the cervix and vagina. We recommend popularizing HPV genotyping in women with high risk factors for the early diagnosis and prevention of cervical cancer.

Genotype distribution and the relative risk factors for human papillomavirus in Urumqi, China

The aim of this study was to investigate human papillomavirus (HPV) infection and HPV genotype distributions in Urumqi, Xinjiang, China. The related risk factors for high-risk HPV infection was also analyzed. A stratified cluster sampling method was used for the population-based cervical cancer screening of women aged 18–69 years in the Urumqi Saybagh district. Exfoliated cervical cell samples were collected for liquid-based cytology detection and HPV genotyping DNA microarrays. Education level, number of sexual partners, condom use and occupation were used in the multivariate analysis model. The HPV infection rate of women working in service industries was significantly higher compared with those of white-collar workers, community residents and migrant workers. The 35–44-year-old migrant worker group had the highest HPV infection rates among all of the groups in the three different age ranges. The number of marriages, education level, smoking history, number of abortions, use of condoms, number of sexual partners, number of sexual partners in the past five years and occupation were all associated with female HPV infection rate (P<0.05). The 35–44-year-old women were the age group with the highest HPV infection rate. The HPV infection rate of females in service industries was the highest. Education level and condom use were protective factors of HPV infection, while the number of sexual partners and occupation were risk factors for HPV infection.

The prevalence and risk factors of human papillomavirus in female sex workers.

Human papillomavirus virus (HPV) is the major causative factor for cervical cancer, and sex workers are at high risk for HPV infection. In this study, we aimed to estimate the prevalence and risk factors of HPV infection among female sex workers (FSWs). The study included 239 brothel-based FSWs who work in Izmir, Turkey. A self-administered questionnaire for risk factors was completed, and cervical brush samples were taken for HPV detection and typing. HPV detection and typing were performed by multiplex polymerase chain reaction (PCR) and reverse hybridization methods. The risk factors related to HPV infection were determined by multivariate analysis. The prevalence of HPV among FSWs was 20.1%. HPV18 was the most common type (40%), followed by HPV16 (17%) and HPV50 (15%). Logistic regression analysis revealed that being less than 30 years of age, having a high frequency of sexual contacts, smoking, and lack of condom use were significantly associated with HPV infection. FSWs have a high prevalence of HPV infection and are at increased risk for cervical cancer. As they are a priority group for active follow-up, national strategies for reducing HPV among FSWs and regular cervical cancer screening programs should be implemented for this population.

Oral Human Papillomavirus in Men Having Sex with Men: Risk-Factors and Sampling

BackgroundHuman papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma is becoming more common. We examined prevalence and risk factors for oral HPV among men who have sex with men (MSM) and compared sampling and transport methods.MethodsIn 2010, 500 MSM (249 HIV-positive) attending Melbourne Sexual Health Centre answered a questionnaire, swabbed their mouth and throat and collected a gargled oral rinse sample. Half the oral rinse was transported absorbed in a tampon (to enable postage). HPV was detected by polymerase chain reaction, and genotyped by Roche Linear Array®. Men with HPV 16 or 18 were retested after six months.ResultsAny HPV genotype was detected in 19% (95% confidence intervals (CI) 15–25%) of HIV-infected men and 7% (95% CI 4–11%) of HIV-negative men (p<0.001), and HPV 16 was detected in 4.4% (95% CI 2–8%) of HIV-infected men and 0.8% (0.1–2.8%) of HIV-negative men. Oral HPV was associated with: current smoking (adjusted odds ratio (aOR) 2.2 (95%CI: 1.2–3.9)), time since tooth-brushing (aOR per hour 0.87, 95%CI: 0.8–0.96) and number of lifetime tongue-kissing partners aOR 3.2 95%CI: (1.2–8.4) for 26–100 partners and 4.9 95%CI: (1.9–12.5) for>100 partners. Lifetime oral-penile sex partner numbers were significantly associated in a separate model: aOR 2.8(1.2–6.3) for 26–100 partners and 3.2(1.4–7.2) for>100 partners. HPV 16 and 18 persisted in 10 of 12 men after a median six months. Sensitivities of sampling methods compared to all methods combined were: oral rinse 97%, tampon-absorbed oral rinse 69%, swab 32%.ConclusionsOral HPV was associated with HIV infection, smoking, recent tooth-brushing, and more lifetime tongue-kissing and oral sex partners. The liquid oral rinse sample was more sensitive than a tampon-absorbed oral rinse or a self-collected swab.

Mitomycin in Anal Cancer: Still the Standard of Care

A 52-year-old woman presents with a 2-month history of bright red blood per rectum. Her bleeding is associated with bowel movements and a sense of incomplete evacuation. She denies fecal incontinence or change in stool caliber. On digital rectal examination, the tumor is palpated approximately 3 cm from the anal verge, posterior and slightly to the right, positioned at the top of the anal canal and extending into the rectum, measuring approximately 2.5 cm. Additionally, a firm 1.5-cm left-sided inguinal node is palpated. The patient is then referred for colonoscopy, which reveals a mass in the anal canal; biopsy of the mass shows squamous cell carcinoma. Positron emission tomography-computed tomography (PET-CT) demonstrates thickening in the low rectum with [(18)F]fluorodeoxyglucose (FDG) avidity (Figs 1A, 1B). The left inguinal node is visualized, as is a perirectal lymph node with associated FDG avidity (Figs 1C, 1D). The patient is staged as having T2N3 squamous cell carcinoma of the anal canal (Table 1). Her medical history is otherwise unremarkable, including for HIV, prior abnormal Papanicolaou smears, and other risk factors for human papillomavirus (HPV) exposure.

Abstract IA16: Susceptibility to neoplasia following HPV infection.

Abstract Cervical cancer is caused by persistent infection with one of approximately a dozen carcinogenic human papillomavirus (HPV) infections. HPV16 is the most carcinogenic HPV type, causing one half of cases worldwide. Cervical cancer arises via three well-defined steps: acute HPV infection; viral persistence linked to development of a high-grade intraepithelial lesion, and invasion. Infections peak in late adolescence and early adulthood, high-grade lesions grow superficially in the years following infection, and invasion of high-grade lesions typically takes decades to occur. Host susceptibility given exposure to HPV is best considered by stage of the carcinogenic process. Infection is nearly ubiquitous among sexually active women, who appear (at our present state of knowledge) to be universally susceptible if previously unexposed. Common exposure leads to at least partial type-specific immunity as women age. Virtually all infections “clear” within 1-2 years and failure to clear, i.e., persistence, is highly associated with development of a high-grade lesion. Susceptibility to viral persistence is poorly understood, but is apparently the major determinant of carcinogenic risk from infection. If undiagnosed and untreated, high-grade lesions invade in a substantial minority of cases and we have determined no definitively established determinants of susceptibility to invasion. Accordingly, this talk will focus on what is known about risk factors for HPV persistence/high-grade lesions given HPV infection. The risk factors can be divided conceptually into three groups: 1) viral factors, 2) host behavioral factors, and 3) intrinsic host factors. Definite viral factors include HPV genetic factors (type and variant lineage) and HPV epigenetic factors (viral methylation). Established host behavioral factors include smoking, long-term oral contraceptive use, and multiparity; the associations are firm but mechanisms are not known. The few known intrinsic host factors include immune status (e.g., HIV immunosuppression), possibly specific HLA associations, and possibly some common genetic variants and methylation patterns. The leading candidates will be mentioned. Understanding of the viral-host interaction has led to promising biomarkers used to distinguish between acute HPV infection and high-grade lesions, most notably p16 staining, a marker of disruption of the Rb pathway. Citation Format: Mark Schiffman. Susceptibility to neoplasia following HPV infection. [abstract]. In: Proceedings of the AACR Special Conference on Post-GWAS Horizons in Molecular Epidemiology: Digging Deeper into the Environment; 2012 Nov 11-14; Hollywood, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(11 Suppl):Abstract nr IA16.

Sexual behaviour and less frequent bathing are associated with higher human papillomavirus incidence in a cohort study of uncircumcised Kenyan men

ObjectivesData on the acquisition of human papillomavirus (HPV) infection in men are limited, especially from developing regions including Africa. The objective of this study was to characterise and determine the...

Prevalence, Incidence, and Risk Factors for Human Papillomavirus 16 Seropositivity in Australian Homosexual Men

Human papillomavirus 16 (HPV16) has been causally associated with approximately 70% of anal cancers. This cancer is markedly increasing among homosexual men. There is limited knowledge of the epidemiology and natural history of anal HPV infection in homosexual men. Behavioral data and sera for antibodies to HPV16 L1 were collected annually for 1427 HIV-negative and 245 HIV-positive Australian homosexual men. Seroprevalence, seroincidence, and risk factors were calculated. Among HIV-negative men, 25.4% were HPV16 seropositive at baseline compared with 44.3% of HIV-positive men. HPV16 seroincidence was 3.1/100 person-years among HIV-negative men and 1.3/100 person-years among HIV-positive men. Seroincidence among HIV-negative men remained >3% per year until 45 years of age, before declining. In multivariate analyses of data from HIV-negative men, seroprevalent HPV16 was associated with sexual risk behaviors and seropositivity for several viral sexually transmissible infections. Seroincident HPV16 was associated with younger age and unprotected anal intercourse with HIV-positive partners. Among men who predominantly practiced insertive anal intercourse, circumcision was associated with a 57% reduction in seroincident HPV16 (hazard ratio = 0.43, 95% confidence interval: 0.21-0.88, P = 0.021). HPV16 seroincidence remained common in men until their mid 40s suggesting that vaccination may be protective in sexually active young gay men. Both HPV16 seroprevalence and seroincidence correlated well with markers of higher risk sexual activity, particularly receptive anal sexual practices. An association between circumcision and decreased HPV16 seroconversion in HIV-negative men who preferred the insertive position in anal sex was observed.

Squamous Cell Carcinoma of the Oral Cavity in Nonsmoking Women: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer?

To describe occurrences of oral squamous cell carcinoma (SCC) in patients who had received long-term pegylated liposomal doxorubicin (PLD) for ovarian cancer. In our cohort of patients on maintenance PLD for ovarian and related mullerian epithelial malignancies, we encountered two patients with invasive SCC of the oral cavity (one of them multifocal) and one with high-grade squamous dysplasia. Review of patients at our institution receiving PLD for recurrent ovarian cancer identified three additional patients. The duration of treatment, cumulative PLD dose, human papillomavirus (HPV) positivity, BRCA status, stage at diagnosis, outcome, and other characteristics are reviewed. All five cases were nonsmokers with no known risk factors for HPV and four were negative for p16 expression. Four of the patients had known BRCA mutations whereas one tested negative. Cumulative doses of PLD were >1,600 mg/m2 given over 30-132 months. Three had SCCs staged as T1N0 oral tongue, alveolar ridge (gingival), and multifocal oral mucosa; one had a T2N0 oral tongue; and one had dysplasia. After excision, two were given radiation but recurred shortly thereafter; the others remain well and have had no further exposure to cytotoxic drugs, including PLD. Awareness of this possible long-term complication during PLD treatment should enhance the likelihood of early detection of oral lesions in these patients. Decisions to continue maintenance PLD after complete response of the original cancer should perhaps consider the benefits of delaying ovarian cancer recurrence versus the possible risk for a secondary cancer.

Prevalence of Chlamydia trachomatis endocervical infection in systemic lupus erythematosus patients and evaluation of the risk for HPV-induced lesions

Chlamydia trachomatis (CT) is the most common bacterial cause of sexually transmitted disease. It has been associated with arthritis and it is a risk factor for human papillomavirus (HPV)-induced lesions. There are few studies on the frequency of CT infection among systemic lupus erythematosus (SLE) patients. The aim of this study was to determine the prevalence of endocervical CT infection among SLE patients and evaluate whether or not CT infection is a risk factor for HPV-induced lesions. A cross-sectional study included a group of patients who fulfilled the American College Rheumatology criteria for a definite diagnosis of SLE and a control group of non-SLE female individuals from Bahia, Brazil. Polymerase chain reaction was used on endocervical swab specimens to test for CT; a gynecological examination including a cervical cytology and biopsy was done for the identification of HPV lesions. A total of 105 SLE patients were studied, and the control group was composed of 104 age-matched apparently normal women. The prevalence of CT endocervical infection was 3.0 % [confidence interval (CI) 95 % = 0.6-8.0 %] in the SLE group and 5.0 % (95 % CI = 2.0-11.0 %) in the control group; the prevalence ratio was 0.60 (95 % CI = 0.1-2.5). The prevalence of vulvar condyloma was higher among SLE patients (11.0 vs. 1.0 %, p < 0.001), as were the prevalences of low-grade lesion (12.0 vs. 1.0 %, p < 0.001) and cervical intraepithelial neoplasia 1 (9.0 vs. 1.0 %, p = 0.02). There was no association between the presence of HPV lesions and CT infections. However, the small number of patients with CT prevents a definite conclusion from being drawn. The prevalence of endocervical CT infection in women with SLE is low and similar to that of the normal population. This suggests that this infection has no role in the pathogenesis of SLE or the development of HPV-induced lesions.

Transitional Probability-Based Model for HPV Clearance in HIV-1-Positive Adolescent Females

BackgroundHIV-1-positive patients clear the human papillomavirus (HPV) infection less frequently than HIV-1-negative. Datasets for estimating HPV clearance probability often have irregular measurements of HPV status and risk factors. A new transitional probability-based model for estimation of probability of HPV clearance was developed to fully incorporate information on HIV-1-related clinical data, such as CD4 counts, HIV-1 viral load (VL), highly active antiretroviral therapy (HAART), and risk factors (measured quarterly), and HPV infection status (measured at 6-month intervals).Methodology and FindingsData from 266 HIV-1-positive and 134 at-risk HIV-1-negative adolescent females from the Reaching for Excellence in Adolescent Care and Health (REACH) cohort were used in this study. First, the associations were evaluated using the Cox proportional hazard model, and the variables that demonstrated significant effects on HPV clearance were included in transitional probability models. The new model established the efficacy of CD4 cell counts as a main clearance predictor for all type-specific HPV phylogenetic groups. The 3-month probability of HPV clearance in HIV-1-infected patients significantly increased with increasing CD4 counts for HPV16/16-like (p<0.001), HPV18/18-like (p<0.001), HPV56/56-like (p = 0.05), and low-risk HPV (p<0.001) phylogenetic groups, with the lowest probability found for HPV16/16-like infections (21.60±1.81% at CD4 level 200 cells/mm3, p<0.05; and 28.03±1.47% at CD4 level 500 cells/mm3). HIV-1 VL was a significant predictor for clearance of low-risk HPV infections (p<0.05). HAART (with protease inhibitor) was significant predictor of probability of HPV16 clearance (p<0.05). HPV16/16-like and HPV18/18-like groups showed heterogeneity (p<0.05) in terms of how CD4 counts, HIV VL, and HAART affected probability of clearance of each HPV infection.ConclusionsThis new model predicts the 3-month probability of HPV infection clearance based on CD4 cell counts and other HIV-1-related clinical measurements.

Risk Factors for Oral HPV Infection among a High Prevalence Population of HIV-Positive and At-Risk HIV-Negative Adults

Human papillomavirus (HPV) is an important risk factor for oropharyngeal cancer. Individuals with human immunodeficiency virus (HIV) have higher oral HPV prevalence but the risk factors for oral HPV infection are not well understood for either HIV-positive or HIV-negative individuals. This study was nested within the Multicenter AIDS Cohort Study (MACS; men) and Women Interagency HIV Study (WIHS; women) cohorts. Exfoliated oral epithelial cells were collected from 379 HIV-positive and 266 at-risk HIV-negative individuals using a rinse and gargle with Scope mouthwash. Samples were tested for 36 types of HPV DNA using PGMY09/11 consensus primers and reverse line blot hybridization. Risk factors for oral HPV infection were explored using logistic regression with generalized estimating equations in this cross-sectional analysis. Prevalent oral HPV infection was common (34%), including HPV16 infection in 5.7% of participants. HIV-positive individuals had increased odds of prevalent oral HPV infection compared with HIV-negative individuals [adjusted OR = 2.1; 95% confidence interval (CI), 1.6-2.8]. Risk factors for prevalent oral HPV differed in HIV-positive and HIV-negative participants. Among HIV-negative individuals, higher number of recent oral sex or rimming partners were strong risk factors for prevalent oral HPV infection (each P(trend) < 0.01). In contrast, among HIV-positive individuals, lower CD4 T-cell count (P(trend) < 0.001) and higher number of lifetime sexual partners (P(trend) = 0.03) were strong risk factors. Oral HPV prevalence was elevated in HIV-positive individuals after controlling for differences in cigarette smoking and sexual behavior, supporting the possibility that HIV may affect the natural history of oral HPV. Immunosuppression may contribute to increased persistence or progression of oral HPV infection.

Burden of Human Papillomavirus among Haitian Immigrants in Miami, Florida: Community-Based Participatory Research in Action

Background. Haitian immigrant women residing in Little Haiti, a large ethnic enclave in Miami-Dade County, experience the highest cervical cancer incidence rates in South Florida. While this disparity primarily reflects lack of access to screening with cervical cytology, the burden of human papillomavirus (HPV) which causes virtually all cases of cervical cancer worldwide, varies by population and may contribute to excess rate of disease. Our study examined the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV infection in Little Haiti. Methods. As part of an ongoing community-based participatory research initiative, community health workers recruited study participants between 2007 and 2008, instructed women on self-collecting cervicovaginal specimens, and collected sociodemographic and healthcare access data. Results. Of the 242 women who contributed adequate specimens, the overall prevalence of HPV was 20.7%, with oncogenic HPV infections (13.2% of women) outnumbering nononcogenic infections (7.4%). Age-specific prevalence of oncogenic HPV was highest in women 18–30 years (38.9%) although the prevalence of oncogenic HPV does not appear to be elevated relative to the general U.S. population. The high prevalence of oncogenic types in women over 60 years may indicate a substantial number of persistent infections at high risk of progression to precancer.

Epidemiologic Risk Profile of Human Papillomavirus Infections in Human Immunodeficiency Virus-Positive Chinese Women

The aim of this study was to evaluate the prevalence and risk factors of human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)-positive women in China. To this end, we enrolled 200 HIV-positive and 182 HIV-negative women in this cross-sectional cohort study. The following sampling methods were used: (i) structured interview, (ii) CD4 cell counts, and (iii) cervical specimens. HPV genotype (total 23 types) was analyzed using polymerase chain reaction assay. Logistic regression analysis was used to identify independent causative factors for HPV infection. The prevalence of HPV infection was 3-fold higher in the HIV-positive women than in the HIV-negative women. The overall prevalences of HPV infection, high risk (HR)-HPV infection, and multiple HPV infections in the HIV-positive women were 36.5%, 33.5%, and 13.0%, respectively, and the corresponding values in HIV-negative women were 12.1%, 10.4%, and 6.0%, respectively (P < 0.05). The types of HR-HPVs were similar in the HIV-positive and HIV-negative women (HPV-16, -52, -58, and -18), and the prevalences of infections by these viruses were 1.5- to 3-fold higher in the HIV-positive group than in the HIV-negative group. HR-HPV infection among the HIV-positive women was associated with three factors: low CD4 count (OR for 200 ≤ CD4 ≤ 350 and CD4 < 200/µL were 2.11 and 3.13, respectively), HIV infection through sexual contact (OR, 7.90; 95% CI, 2.38-14.60), and having HIV-positive sexual partners (OR, 2.02; 95% CI, 1.03-3.95). We found that the prevalence of HPV infection among the HIV-positive Chinese women was higher than that among the HIV-negative women; moreover, among the HIV-positive women, factors associated with HIV infection were risk factors for HR-HPV infection.

The role of human papillomavirus on sperm function

To review the role of human papillomavirus (HPV) on sperm parameters, fertility and implication of the use of infected sperm cells in assisted reproduction. HPVs are agents of the most common sexually transmitted disease and can lead to warts and cancers both in men and women.A high incidence of HPV infection has been demonstrated in sperm from sexually active men with and without risk factors for HPV and from infertile patients. Semen infection is associated to an impairment of sperm parameters suggesting a possible role in male infertility. Interestingly, it has been demonstrated that when HPV is present in semen only a percentage of total cells are infected and the virus can be localized in sperm or in exfoliated cells with different impact on sperm motility. Moreover, infected sperm are able to penetrate the oocyte, to deliver HPV genome in the oocyte and HPV genes can be actively transcribed by the fertilized oocyte. Recently an increased risk of pregnancy loss has been demonstrated in couples undergoing in-vitro fertilization and particularly when HPV DNA was present in semen samples of male partners. To date, no effective treatment, control strategy and prevention is provided for men despite the reported high incidence of HPV semen infection. Because this infection in men is also a problem for partners, and because growing evidence suggests that semen infection may cause infertility and early miscarriage, more attention should be paid to male HPV infection. This study reviews the more recent literature about the role of HPV infection on sperm function and human reproduction.

Epidemiology of HPV genotypes in Uganda and the role of the current preventive vaccines: A systematic review.

BackgroundLimited data are available on the distribution of human papillomavirus (HPV) genotypes in the general population and in invasive cervical cancer (ICC) in Uganda. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18 responsible for causing about 70% of ICC cases in the world, such information is crucial to predict how vaccination and HPV-based screening will influence prevention of ICC.MethodsTo review the distribution of HPV infection and prevalent genotypes, electronic databases (e.g. PubMed/MEDLINE and HINARI) were searched for peer reviewed English articles on HPV infection up to November 30, 2010. Eligible studies were selected according to the following criteria: DNA-confirmed cervical or male genital HPV prevalence and genotypes, HPV incidence estimates and HPV seroprevalence among participants.ResultsTwenty studies were included in the review. Among HIV negative adult women, the prevalence of HR-HPV infections ranged from 10.2% -40.0% compared to 37.0% -100.0% among HIV positive women. Among HIV positive young women aged below 25 years, the prevalence of HR-HPV genotypes ranged from 41.6% -75.0% compared to 23.7% -67.1% among HIV negative women. Multiple infections with non vaccine HR-HPV genotypes were frequent in both HIV positive and HIV negative women. The main risk factors for prevalent HPV infections were age, lifetime number of sexual partners and HIV infection. Incident infections with HR-HPV genotypes were more frequent among adult HIV positive than HIV negative women estimated at 17.3 and 7.0 per 100 person-years, respectively. Similarly, incident HR-HPV among young women aged below 25 years were more frequent among HIV positive (40.0 per 100 person-years) than HIV negative women (20.3 per 100 person-years) women. The main risk factor for incident infection was HIV infection. HPV 16 and 18 were the most common genotypes in ICC with HPV 16/18 contributing up to 73.5% of cases with single infections.Among uncircumcised adult HIV positive males, HR-HPV prevalence ranged from 55.3% -76.6% compared to 38.6% -47.6% in HIV negative males. Incident and multiple HR-HPV infections were frequent in HIV positive males. Being uncircumcised was the main risk factor for both prevalent and incident HPV infection.ConclusionInfections with HR-HPV genotypes were very common particularly among HIV positive individuals and young women irrespective of HIV status. Given the high prevalence of HIV infection, HPV-associated conditions represent a major public health burden in Uganda. However, although the most common HPV genotypes in ICC cases in Uganda were those targeted by current preventive vaccines, there were a large number of individuals infected with other HR-HPV genotypes. Technology allowing, these other HR-HPV types should be considered in the development of the next generation of vaccines.

Incidence and Predictors of Human Papillomavirus-6, -11, -16, and -18 Infection in Young Norwegian Women

Natural history data on human papillomavirus (HPV) incidence and its risk factors have not been reported on from young women in Norway. We report on incidence and predictors of HPV-6, 11, 16, and 18; 6 or 11; 16 or 18; or all 4. A 48-month prospective study enrolled 898 women aged 16 to 24 between 1998 and 2000. HPV DNA polymerase chain reaction testing of genital tract specimens was performed and risk data collected every 6 months and HPV serology and genital Chlamydia trachomatis testing performed every 12 months. Cumulative incidence was estimated using the Kaplan-Meier method and covariates evaluated in Cox models. Among the women who were HPV DNA- and serology-negative at entry, 48-month cumulative incidences (95% confidence interval) were as follows: HPV-6: 20.0% (17.1-23.4), HPV-11: 2.2% (1.3-3.5), HPV-16: 25.0% (21.7-28.8), HPV-18: 13.6% (11.3-16.4), HPV-6 or -11: 21.5% (18.5-25.0), HPV-16 or -18: 30.4% (26.7-34.5), and HPV-6, -11, -16, or -18: 37.8% (33.6-42.3). Younger age at first intercourse, being single, having no regular partner, reporting new partners, and genital C. trachomatis infection were independent risk factors of incident HPV. Proxies measuring new partnerships and genital C. trachomatis infection predicted incident HPV-6, -11, -16, or -18. Incidence of HPV-6, -11, -16, or -18 in young Norwegian women is high, with more than one-third becoming infected over 48 months.

Prevalence and Risk Factors of Human Papillomavirus (HPV) Infection in Southern Chinese Women – A Population-Based Study

BackgroundPersistent high-risk type Human papillomavirus (HPV) infection is recognized as a necessary cause of cervical cancer. This study aimed to compare the HPV prevalence and risk factors between women residing in Hong Kong (HK) and Guangzhou (GZ) region of China.Methodology/Principal FindingsA total of 1,570 and 1,369 women were recruited from HK and GZ, respectively. The cytology samples were collected and tested for HPV infection. The overall and type-specific HPV prevalence and the potential risk factors for acquisition of HPV infection were studied. Women with normal cytology in the GZ cohort had significantly higher HPV prevalence (10%) than those in the HK cohort (6.2%, p<0.001). The patterns of the age-specific HPV prevalence were also different between the two cohorts. In the HK cohort, women at the age of 20–29 years old had the highest prevalence and a second peak was observed in the age of ≥60 years old. In the GZ cohort, the highest HPV prevalence was also observed in 20–29 years old but declined as the age increased and a second peak was not seen. HPV16 and HPV52 were the most common high-risk types found in the HK and GZ cohorts, respectively. Age was the most consistently observed independent risk factor for HPV infection in the HK, while the number of sexual partners had association in the GZ cohort.Conclusions/SignificanceOur study provides the current status and the epidemiological characteristics of HPV prevalence in Southern Chinese women. The results strongly suggested that population education and the effective cervical cancer screening would be vital in the prevention of cervical cancer.

Prevalence of human papillomavirus infection among female sex workers in Bulgaria

The present study estimates the prevalence and risk factors of human papillomavirus (HPV) infection among female sex workers (FSWs) in Bulgaria. HPV DNA was detected by polymerase chain reaction (PCR) in 43.4% of FSWs. HPV16 was the most common type, found in 17.0% of samples, followed by HPV31 (9.4%). Age and smoking were associated with a significantly greater risk of being infected. The results of this study indicate that FSWs in Bulgaria are at increased risk for cervical cancer and represent an important source of HPV infection for the general population in the country. They should be considered as a priority group in cervical cancer control programmes.