Although the number of newly diagnosed cases of HiV is decreasing worldwide, those in Korea have been steadily on the rise, especially among adolescents (ages 10-19 years) and young adults (ages 20-29 years). To identify the characteristics in the new diagnosis among these age groups, we analyzed HIV testing sizes and HIV prevalence under the national HIV surveillance system in Korea in the last six years. We collected data of HIV tests conducted at Blood Banks (BB), Public Health Centers (PHCs), and Military Manpower Administration (MMA) nationwide every year from 2010 to 2015, except for anonymous tests. HIV prevalence, calculated as the number of new HIV-diagnosed cases per 10,000 test-takers per year, was analyzed according to sex, age, institution, and reason for HIV testing. Data were analyzed using logistic regression. In the three testing institutes, there were new cases of HIV with 50% and 75% of cases diagnosed in young adults and adolescents, respectively. The total size of HIV tests at the three sites was approximately 3.5 million tests per year; 80% of these were conducted in BBs, 10% in PHCs, and 10% in MMA. HIV prevalence, according to age, increased across all age groups for the six years, especially prevalent in young adults doubled during that period (1.01 per 10,000 testtakers in 2010, 2.45 in 2015). HIV prevalence among the "suspected" young male adults who visited PHCs for tests, was highest during the six years, increasing 6.5 times in the last two years (315.79 per 10,000 test-takers in 2014, 335.55 in 2015) compared to before 2014. We identified the characteristics of growing HiV infection in Korea as the increase of HiV prevalence among the suspected of young male adults at PHCs. Further, we propose that HIV prevalence in MMA can be used as an essential index for national HIV surveillance of adolescent boys in Korea. HIV infection, known to the public since the early 1980s, has been rapidly spreading worldwide through sexual contact, vertical transmission, blood transfusions, and needle sharing for injection drug use (IDU). The HIV epidemic has different transmission routes and the speed of spreading across countries 1. Globally, for more than 35 years, approximately 78 million individuals have been infected with HIV, with 35 million HIV-related deaths, and 37 million people are currently living with HIV 2. The first HIV-infection in Korea was identified in 1985, and over the next 30 years or so, approximately 15,000 individuals were identified as HIV-infected. It was reported that more than 99% of individuals diagnosed with HIV in Korea were infected via sexual contact, while transmission through blood transfusion, vertical transmission, and needle sharing for IDU was infrequent 3. Soon after the discovery of HIV in Korea, the country initiated a prevention program focused on HIV transmission reduction by regularly performing HIV screening tests on high-risk groups for sexually transmitted infections (STI) and extending it to other groups 4-6. Hospitals or clinics and public health centr...

IMPORTANCEIn combination with a decreased risk of AIDS-defining cancers and improved survival of people infected with HIV, the burden of non-AIDS-defining cancer has increased markedly.Although a substantial number of studies have measured the cancer risk among people with HIV in developed countries, little research has been conducted on the risk of cancer in HIV-infected people in Asia. OBJECTIVE To examine the cancer incidence and the estimated risk of cancer among people in Korea infected with HIV compared with the general population.

ObjectivesSince 2007, human papillomavirus (HPV) vaccines have been administered for the prevention of cervical cancer in Korea. We investigated the status of HPV vaccination among HPV-infected adult women with abnormal cervical cytology before the introduction of National Immunization Program.MethodsFrom 2010 to 2016, HPV-positive women (age, 20–60 years) with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion (LSIL) were enrolled from five hospitals across Korea. Their HPV genotype, epidemiologic, and clinical data, including HPV vaccination history, were obtained. We compared the epidemiological characteristics and prevalence of HPV-16/18 genotypes between vaccinated and unvaccinated women.ResultsAmong the 1,300 women, approximately 26% had a history of vaccination. Vaccinated patients were significantly younger, unmarried, and had a higher education level than unvaccinated women. For HPV-vaccinated individuals by vaccine dose, there was a significant younger age at vaccination initiation (p=0.025), longer duration from HPV vaccination to Pap test date (p=0.001), and lower proportion of HPV-16/18 (p=0.028) in the women with three doses. There was a significantly lower prevalence of HPV-16/18 genotypes in women who were vaccinated at least 12 months prior than in unvaccinated women (adjusted prevalence ratio [aPR]=0.51; 95% confidence interval [CI]=0.29–0.88). For women with LSIL, the prevalence of the HPV-16/18 genotypes was significantly lower in women who were vaccinated more than 12 months prior than in unvaccinated women (aPR=0.35; 95% CI=0.13–0.96).ConclusionThis study highlighted the status of HPV vaccination and the prevalence of HPV-16/18 genotypes among HPV-infected women with abnormal cervical cytology according to HPV vaccination. It provides preliminary information regarding the status of HPV vaccination among Korean adult women.

ObjectiveHuman papillomavirus (HPV) infection is the most important risk factor for cervical cancer, which progresses from precursor lesions with no symptom if left untreated. We compared the risk of cervical dysplasia among HPV-positive Korean women based on HPV types and infection patterns.MethodsWe observed participants of a 5-year multicenter prospective cohort study, comprising HPV-positive women with either atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion of the cervix at their enrollment. Follow-ups, comprising cytology and HPV DNA testing results, were included in the final analysis. Incidence was calculated for each infection pattern (persistent infection, incidental infection, and clearance). To investigate cervical dysplasia risk, we used Cox proportional hazard models adjusted for variables that were significantly different among infection patterns. From April 2010 to September 2017, 71 of 1,027 subjects developed cervical dysplasia more severe than high-grade squamous intraepithelial lesion of the cervix.ResultsOf these 71 subjects, persistent infection, incidental infection, and clearance were noted in 30, 39, and 2 individuals, respectively. Based on changes in DNA results during follow-up, cumulative incidence was 27.2%, 10.4%, and 0.5% for persistent infection, incidental infection, and clearance, respectively. Compared to clearance, the adjusted hazard ratios for cervical dysplasia were 51.6 and 24.1 for persistent and incidental infections, respectively (p<0.001).ConclusionIndividuals persistently infected with the same HPV types during the follow-up period had the highest risk of severe cervical dysplasia. Hence, it is necessary to monitor HPV types and infection patterns to prevent severe cervical precancerous lesions.

Background Persistent human papillomavirus (HPV) infection is a key factor for the development and progression of cervical cancer. We sought to identify the type-specific HPV prevalence by cervical cytology and assess disease progression risk based on high-risk persistent HPV infection in South Korea. Methods To investigate the HPV prevalence by Pap results, we searched seven literature databases without any language or date restrictions until July 17, 2019. To estimate the risk of disease progression by HPV type, we used the Korea HPV Cohort study data. The search included the terms “HPV” and “Genotype” and “Korea.” Studies on Korean women, type-specific HPV distribution by cytological findings, and detailed methodological description of the detection assay were included. We assessed the risk of disease progression according to the high-risk HPV type related to the nonavalent vaccine and associated persistent infections in 686 HPV-positive women with atypical squamous cells of uncertain significance or low-grade squamous intraepithelial lesions from the Korea HPV Cohort Study. Type-specific HPV prevalence was the proportion of women positive for a specific HPV genotype among all HPV-positive women tested for that genotype in the systematic review. Results We included 23 studies in our review. HPV-16 was the most prevalent, followed by HPV-58, -53, -70, -18, and -68. In women with high-grade squamous intraepithelial lesions, including cancer, HPV-16, -18, and -58 were the most prevalent. In the longitudinal cohort study, the adjusted hazard ratio of disease progression from atypical squamous cells of uncertain significance to high-grade squamous intraepithelial lesions was significantly higher among those with persistent HPV-58 (increase in risk: 3.54–5.84) and HPV-16 (2.64–5.04) infections. Conclusions While HPV-16 was the most prevalent, persistent infections of HPV-16/58 increased the risk of disease progression to high-grade squamous intraepithelial lesions. Therefore, persistent infections of HPV-16 and -58 are critical risk factors for cervical disease progression in Korea. Our results suggest that equal attention should be paid to HPV-58 and -16 infections and provide important evidence to assist in planning the National Immunization Program in Korea.