High-risk HPV infection after five years in a population-based cohort of Chilean women

Abstract

BackgroundThe need to review cervical cancer prevention strategies has been triggered by the availability of new prevention tools linked to human papillomavirus (HPV): vaccines and screening tests. To consider these innovations, information on HPV type distribution and natural history is necessary. This is a five-year follow-up study of gynecological high-risk (HR) HPV infection among a Chilean population-based cohort of women.FindingsA population-based random sample of 969 women from Santiago, Chile aged 17 years or older was enrolled in 2001 and revisited in 2006. At both visits they answered a survey on demographics and sexual history and provided a cervical sample for HPV DNA detection (GP5+/6+ primer-mediated PCR and Reverse line blot genotyping). Follow-up was completed by 576 (59.4%) women; 45 (4.6%) refused participation; most losses to follow-up were women who were unreachable, no longer eligible or had missing samples. HR-HPV prevalence increased by 43%. Incidence was highest in women < 20 years of age (19.4%) and lowest in women > 70 (0%); it was three times higher among women HR-HPV positive versus HPV negative at baseline (25.5% and 8.3%; OR 3.8, 95% CI 1.8-8.0). Type-specific persistence was 35.3%; it increased with age, from 0% in women < 30 years of age to 100% in women > 70. An enrollment Pap result ASCUS or worse was the only risk factor for being HR-HPV positive at both visits.ConclusionsHR-HPV prevalence increased in the study population. All HR-HPV infections in women < 30 years old cleared, supporting the current recommendation of HR-HPV screening for women > 30 years.

HPV16 genetic variation and the development of cervical cancer worldwide

“…We designed a multicentre case–control study based upon the IARC biobank of HPV16-positive samples, with additional supplementation of HPV16-positive samples derived from cervical screening programmes in Italy (Sideri et al , 2009; Del Mistro et al , 2010) and Chile (Ferreccio et al , 2011). Cases were defined as women with HPV16-positive histologically confirmed cervical cancer, whereas controls included women with HPV16-positive normal cytology, atypical squamous cells of unknown significance or low-grade squamous intra-epithelial lesions.…”

Attitudes Towards Human Papilloma Virus Vaccination in the Latin American Andean Region

“…Multiple HPV type infections that include HPV-18 form 47% of HPV infections in Colombia, and 56% in Peru, which are higher than worldwide incidence at 20% [22]. From 2001 to 2006 prevalence of HPV-16 and -18 increased from 2.6% to 6.1% in a cohort of 576 low socio-economic status Chilean females ranging from 17-to older than 70-years-old [27]. Consistent with this, from 2012 to 2016 in seven centers in Santiago, dependent upon population subgroup, the combined prevalence of HPV-16 and HPV-18 in cervical cytology ranged from 3.2% to 7.6% [28,29].…”

Serological prevalence and persistence of high-risk human papillomavirus infection among women in Santiago, Chile

“…A population-based survey of adult Chilean women reported an overall prevalence of HR-HPV genital infection (any oncogenic type) of 15%, with the highest prevalence observed in women under 25 years old [7]. A subsequent study confirmed that, among women in Santiago, Chile, cervical infection with HR-HPV peaks at young ages (< 20 years old) and then steadily decreases to stabilize around age 40 years, and increases again after age 60 years [8]. …”