Prevalence of high-risk HPV genotypes, categorised by their quadrivalent and nine-valent HPV vaccination coverage, and the genotype association with high-grade lesions

Abstract

BackgroundThe new nine-valent vaccine against human papillomavirus (HPV) includes the four HPV genotypes (6, 11, 16, and 18) that are targeted by the older quadrivalent HPV vaccine, plus five additional oncogenic types (31, 33, 45, 52, and 58) remain significantly associated with high grade lesions. We aimed to determine the prevalence of high-risk HPV genotypes in unvaccinated subjects and the association of these genotypes with the incidence of high-grade lesions. We also assessed which, if either, of these two HPV vaccines could have prevented these cases.MethodsThis cross-sectional study, conducted from 4 January 2010 to 30 December 2011, was composed of 595 women attending the Hospital General Universitario de Elche (Spain) gynaecology department who were positively screened for opportunistic cervical cancer by pap smears and HPV detection during a routine gynaecological health check. The pap smear results were classified using the Bethesda system. HPV genotyping was performed with the Linear Array HPV genotyping test, and viruses were classified by the International Agency for Research on Cancer assessment of HPV carcinogenicity. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were estimated by logistic regression, adjusting for age and immigrant status. The prevented fraction among those exposed (PFe-adjusted) was determined as a measure of impact.ResultsAt least one of the additional five high-risk HPV genotypes present in the nine-valent HPV vaccine was detected in 20.5% of subjects. After excluding women with genotype 16 and/or 18 co-infection, high-risk genotypes (31, 33, 45, 52, and 58) were associated with a higher risk of intraepithelial lesion or malignancy: adjusted OR = 3.51 (95% CI, 1.29–9.56), PFe-adjusted = 0.72 (95% CI, 0.22–0.90). Genotypes that are still non-vaccine-targeted were detected in 17.98% of the women, but these were not significantly associated with high-grade lesions.ConclusionThe greater protection of the nine-valent HPV vaccine is likely to have a positive impact because, in the absence of genotype 16 or 18 infection, these five genotypes on their own remained significantly associated with high-grade lesions.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4033-2) contains supplementary material, which is available to authorized users.

Knowledge, Attitudes and Perceptions of Immigrant Parents Towards Human Papillomavirus (HPV) Vaccination: A Systematic Review

“…However, cervical cancer is increasing in developing countries where nationwide cervical cancer screening is currently unavailable. It is the second most common cancer in countries with a lower human development index ranking and is the most common cancer in about 28 countries [6,8].…”

Comparison of the long‐term impact and clinical outcomes of fewer doses and standard doses of human papillomavirus vaccine in the United States: A database study

“…More than 150 HPV genotypes have been identified . Persistent HPV infection with one of the 12 high‐risk genotypes identified is causally linked with the development of cervical cancer . High‐risk HPV genotypes 16 and 18 are associated with approximately 70% of all invasive cervical cancers, and low‐risk HPV genotypes 6 and 11 cause 90% of anogenital warts …”

“…2 Persistent HPV infection with one of the 12 high-risk genotypes identified is causally linked with the development of cervical cancer. [3][4][5] High-risk HPV genotypes 16 and 18 are associated with approximately 70% of all invasive cervical cancers, and low-risk HPV genotypes 6 and 11 cause 90% of anogenital warts. 3,[6][7][8] Several prophylactic vaccines targeting various high-risk HPV genotypes have been developed, and they include the bivalent vaccine (HPV-16/18) approved in 2007, the quadrivalent vaccine (HPV-16/18/6/11) approved in 2006, 9 and, more recently, the nonavalent vaccine (HPV-16/18/6/11/31/33/45/52/58) approved in 2014.…”

Significance of the Viral Load of High-risk Hpv in the Diagnosis and Prediction of Cervical Lesions: A Retrospective Study

“…Epidemiological and molecular biological data show that human papillomavirus (HPV) infection can lead to cervical precancerous lesions and CC [7]. HPV is a member of the Papovaviruses family with a core of small double-stranded circular DNA, consisting of 7800-7900 base pairs, which is the smallest DNA virus [8].…”