Human papillomavirus infection among women in South and North Vietnam

Abstract

The incidence rate of invasive cervical carcinoma (ICC) is 4-fold higher in Ho Chi Minh City, in the South of Vietnam, than in Hanoi, in the North. Thus, we explored the prevalence of and the risk factors for human papillomavirus (HPV) infection in these 2 areas. A population-based random sample of married women aged 15-69 years were interviewed and had a gynaecological examination in the urban district of Ho Chi Minh City and in a peri-urban district in Hanoi. HPV DNA detection was performed using a GP5؉/6؉ primermediated PCR enzyme immunoassay. A total of 922 women from Ho Chi Minh and 994 from Hanoi, for whom a Pap smear and HPV-status were available, were evaluated. HPV DNA was detected among 10.9% of women in Ho Chi Minh City and 2.0% in Hanoi (age standardized prevalence, world standard population: 10.6% and 2.3%, respectively). In the 2 areas combined, 30 different HPV types were found, the most common being HPV 16 (in 14 single and 18 multiple infections), followed by HPV 58, 18 and 56. A peak of HPV DNA detection in women younger than age 25 was found in Ho Chi Minh City (22.3%) but not in Hanoi. Major risk factors for HPV DNA detection were indicators of sexual habits, most notably the presence of HSV-2 antibodies, nulliparity and the current use of oral contraceptives. Women in Hanoi showed the lowest HPV prevalence ever reported so far, suggesting that HPV has not spread widely in this population. As expected, HPV prevalence in a population seemed to be closely correlated with ICC incidence rates. © 2003 Wiley-Liss, Inc. Key words: human papillomavirus; herpes simplex virus 2; cervical cancer; cervical dysplasia; VietnamWorldwide, invasive cervical cancer (ICC) is the second most common cancer in women, with approximately 470,000 new cases and 230,000 deaths annually. 1 Approximately 80% of ICC-related deaths occur in developing countries. The incidence of ICC is highest in Latin America, the Caribbean, Sub-Saharan Africa and South Asia and considerably lower in North America and Western Europe. In Vietnam, the ICC incidence rate is intermediate (17.3 per 100,000 women) but, on account of the relatively low incidence for all cancer (101.6/100,000), it is the most common cancer in women with approximately 5,600 new cases and 2,500 deaths per year. 2 The incidence of ICC varies from 6.8/100,000 women in Hanoi, in the North, to 26/100,000 women in Ho Chi Minh City, in the South. 2,3 Infection with high-risk types of human papilloma virus (HPV) is established to be the necessary cause of ICC. 4,5 Recent efforts have focused on the development of both prophylactic and therapeutic HPV vaccines, chiefly targeting the most common oncogenic types HPV 16 and 18. 6 An effective HPV vaccine could benefit populations worldwide, but data on the age-and typespecific distribution of HPV infection in women from different areas are needed for the planning of future vaccination strategies. Population-based information on the distribution of HPV types among women is still limited, 7-9 particularly in Asia. 10 Hungvuong ...

Papillomavirus infection in rural women in southern India

“…Among other HPV types, a relatively high frequency of HPV 42 and HPV 56 (the second most frequent high-risk type in Dindigul) was found in previous IARC surveys (Anh et al, 2003;Thomas et al, 2004). HPV 42 is a low-risk type while HPV 56 seems to be one of the high-risk types like HPV 31, 33, 35, 52, 53 and 58 that is substantially under-represented in invasive cancer compared to preinvasive cervical lesions (Clifford et al, 2003).…”

“…The prevalence of human papillomavirus (HPV) is low in some populations in Asia (Anh et al, 2003) and Europe (de Sanjosé et al, 2003), although it exceeds 15% in women aged 15 -74 years in some parts of Latin America (Molano et al, 2002) and sub-Saharan Africa (Thomas et al, 2004), where incidence rates for cervical cancer are very high (Ferlay et al, 2001). HPV prevalence shows different patterns of infection by age in different populations.…”

Cervical carcinoma in Algiers, Algeria: Human papillomavirus and lifestyle risk factors

“…The prevalence of HPV infection (12.4%) among control women in Algiers was intermediate, between the low prevalence found in some age groups in some parts of Spain 14 and Asia 15 and the high prevalence found in sub-Saharan Africa 16 and Latin America. 17 These differences in the prevalence of HPV in cancerfree women are consistent with the wide variations observed in CC incidence rates (e.g., 2-to 4-fold greater rates in sub-Saharan Africa than in Algeria 1 ).…”

Human papillomavirus infection in women with and without cervical cancer in Nepal

“…Nevertheless, HPV prevalence remained greater than that in other areas in Asia (e.g., 2% in Hanoi, Vietnam [21], 4% in Songkla, Thailand [22]), and in Europe [23].…”

“…Of note, the relationship between education level and HPV prevalence in previous IARC surveys in Asia included inverse [25] and direct associations [21,22] as well as no relationship [16].…”