BackgroundData regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shandong Province, China. Therefore, we investigated the recent HPV prevalence and genotype distribution among females in Shandong and aimed to provide comprehensive data to guide HPV-based cervical cancer screening and HPV vaccination for this population of Chinese women.MethodsHPV testing results of 94,489 females were retrospectively reviewed and extracted from the database of Jinan KingMed Diagnostics, the largest independent pathology laboratory in Shandong Province, China. HPV was detected by a HPV genotyping panel from January 2011 to June 2017. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed.ResultsA total of 26,839 cases (28.4%) were HPV-positive, with 4.3% positive for low- or undetermined-risk HPV (lr-/urHPV)-only, 18.1% positive for high-risk HPV (hrHPV)-only, and 6.1% positive for mixed lr-/urHPV and hrHPV infections. Single HPV infections accounted for 62.8%, while the rest were multiple HPV infections of two or more genotypes. HPV16 (5.8%), HPV52 (5.1%), HPV58 (3.5%), HPV51 (2.6%), and HPV56 (2.3%) were the five most common hrHPV genotypes; while HPV81 (2.8%), HPV53 (2.8%), and HPV6 (2.3%) were the three most common lr-/urHPV genotypes. HPV18 (1.7%) was only the ninth most common hrHPV genotype. HPV16 but not HPV52 was more common in single infections than in multiple infections. The distribution of both mixed lr-/urHPV and hrHPV as well as overall HPV infections demonstrated a bimodal pattern across age groups, of which the first peak appeared in the younger group and the second peak was found in older women. A similar age-specific distribution was observed in multiple infections of three or more subtypes as well. Moreover, the proportion of mixed lr-/urHPV and hrHPV infection significantly increased, while those of lr-/urHPV-only and hrHPV-only infections declined as the number of co-infections increased during the study period.ConclusionThis large daily clinical practice report shows that HPV prevalence and genotype distribution are different in this population, who had limited cervical cancer screening service, compared to those in developed countries. Therefore, different strategies should be developed for HPV-based cervical cancer screening and vaccine-based HPV prevention in Shandong Province.

To perform a systematic review of prospective studies to confirm the role of breastfeeding in motherto-child transmission (MTCT) of hepatitis B virus (HBV).

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BackgroundCurrently, available data regarding previous cervical cytology and high-risk human papillomavirus (hrHPV) test results to detect invasive cervical cancer are limited and controversial in China. Therefore, this retrospective study in a population of Chinese women with invasive cervical carcinoma aimed to gain further insight into the roles of cytology and hrHPV testing in cervical cancer screening.MethodsA total of 1214 cases with a histological diagnosis of invasive cervical cancer were retrieved from the Pathology Database of Jinan KingMed Diagnostics (JKD) over a 5-year period. Previous cytology and hrHPV test results of 469 patients carried out within the year before cancer diagnosis were documented.ResultsA higher percentage of patients who had undergone prior screening had micro-invasive cervical carcinoma than patients who had no prior screening (25.4% vs. 12.1%, P < 0.001). Of the 469 patients with available prior screening results, 170 had cytology alone, 161 had hrHPV testing alone, and 138 had both cytology and hrHPV testing. There was a significantly lower percentage of hrHPV-positive cases with adenocarcinoma than with squamous cell carcinoma (77.8% vs. 96.4%, P = 0.001). The hrHPV test showed a significantly higher sensitivity than cytology alone (94.4% vs. 85.3%, P = 0.006). The overall sensitivity of the combination of cytology and hrHPV testing (98.6%) was much higher than that of cytology alone (P < 0.001) but only marginally higher than that of hrHPV testing alone (P = 0.058).ConclusionsThe results revealed that prior cervical screening can detect a significantly larger number of micro-invasive cervical cancers. The hrHPV test can provide a more sensitive and efficient strategy than cytology alone. As the addition of cytology to hrHPV testing can only marginally increase the efficiency of the hrHPV test, hrHPV testing should be used as the primary screening approach, especially in the low-resource settings of China.