High prevalence of human papillomavirus infection in the female population of Guatemala

Abstract

The potential introduction of the newly licensed HPV-vaccines at affordable prices could play a central role in preventing cervical cancer in middle and low-income countries, where most of the cases occur. In spite of this, basic epidemiological data about HPV and HPV-related lesions are still scarce. To determine the prevalence of cervical abnormalities, HPV prevalence, genotype distribution and related risk factors, we carried out a cross-sectional study in a population from Guatemala that included 297 women from the general population (GP women) and 297 sex workers (SW). All participating women were interviewed and underwent a complete gynecological examination that included collection of cervical cells for cytological diagnosis, HPV DNA detection and typing by PCR methods. Cervical HPV DNA prevalence among GP women and from SW was 38.1% (95% CI: 32.5-43.8) and 67.3% (95% CI: 61.7-72.6), respectively. The prevalence of abnormal cytology among GP women was 7.7% (ASCUS 5 1.4%, LSIL 5 4.7%, ASC-H 5 0.3% and HSIL 5 1.4%) and among SW was 21.6% (ASCUS 5 7.5%, LSIL 5 10.6%, ASC-H 5 1.4% and HSIL 5 2.1%). The most prevalent HPV types among women with normal cytology were HPVs 51 (n 5 30), 66 (n 5 25) and 16 (n 5 25), and among women with HSIL or ASC-H (n 5 14) HPVs 58 (n 5 5) and 16 (n 5 5). Determinants associated with HPV DNA detection were having had an occasional partner during the last 6 months and smoking habit among GP women, and being a minor among SW. HPV and abnormal cytology prevalence is high among women in Guatemala. The introduction of a HPV vaccination program would prevent an important fraction of HPV-related disease burden. ' UICCKey words: human-papillomavirus; abnormal cytology; sex workers; Guatemala; prevalence Cervical cancer is the second most frequent cancer among women in developing and middle income countries.1 The causal role of the human papillomavirus (HPV) in the development of both invasive cervical cancer (ICC) and its precursor lesions (cervical intraepithelial neoplasia or CIN) is well established.2,3 HPV infection shares common risk factors with other sexually transmitted infections (STI), like the number of life-time sexual partners or not using a barrier-method for contraception. Furthermore, HPV is now considered one of the most common STI worldwide. 4 HPV types have been classified as low-risk oncogenicity (LR-HPV) and high-risk oncogenicity (HR-HPV), according to their potential to induce carcinogenesis.5 HR-HPV are highly prevalent in women with high grade intraepithelial lesions (CIN II or III) and this proportion increases in women with ICC in whom it is estimated that around 70% of the cases are related to HPV types 16 and 18.6 Characterized HR-HPV types include HPVs 16,18,31,33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 68, 73 and 82. HPVs 6,11, 40, 42, 43, 44, 54, 61, 70, 72, 81 and CP1068 are considered LR-HPVs. HPV types 26 and 66 are considered as probably carcinogenic. 5The introduction of prophylactic HPV vaccines, which protect against a limited number of HPV types ...

HPV and cervical cancer related knowledge, awareness and testing behaviors in a community sample of female sex workers in China

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Human Papillomavirus Prevalence in a Population of Women Living in Port-au-Prince and Leogane, Haiti

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