Enhanced disease progression due to persistent HPV-16/58 infections in Korean women: a systematic review and the Korea HPV cohort study

Abstract

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.

High prevalence and co-infection of high-risk Human Papillomavirus genotypes among unvaccinated young women from Paraguay

“…Women with normal cytology and persistent HPV-16 infection have an approximately 30% chance of developing high-grade lesions in a 12-month period [ 50 ]. HPV-58 is also included in high-risk group and has been frequently reported in cervical cancer and high-grade lesions in several regions of the world [ 51 ], such as Asia [ 52 , 53 ], Mexico [ 54 , 55 ], Costa Rica [ 43 ], and Brazil [ 56 ]. Given the wide circulation of HPV-58 in the population studied and the evidence of its oncogenic potential, particular attention should be given to HPV-58 infection.…”

Epidemiologic characteristics of high-risk HPV and the correlation between multiple infections and cervical lesions

“…A study revealed that the most common HPV types are HPV-16 and HPV-58 among women with HSIL and cervical cancer [ 30 ]. Another study showed that persistent HPV-16 and HPV-58 infections are risk factors for cervical disease progression in Korea [ 31 ]. Our study also showed that HPV-58 was a common HPV subtype in women with HSIL, CIN3, and cervical cancer, second only to HPV-16.…”

Association between Cervix Intraepithelial Neoplasia (CIN) and High-Risk Human Papillomavirus (HPV) Genotypes in Iraqi Women

“…Previous study founded the most common HR-HPV genotypes infected Korean women at HSIL stages was HPV-16, followed by HPV-52, HPV-58, and HPV-33 [36]. Another study showed that persistent HPV-16 and HPV-58 infections are risk factors for cervical lesions in Korea [37].…”