Prevalence of human papillomavirus in young Italian women with normal cytology: how should we adapt the national vaccination policy?

Abstract

BackgroundHuman Papillomavirus (HPV) is the most common sexually transmitted infection. In Italy, HPV vaccination is now offered free of charge to 12-year-old females. However, some regional health authorities have extended free vaccination to other age-groups, especially to girls under 18 years of age. We conducted a multicentre epidemiological study to ascertain the prevalence of different genotypes of HPV in young Italian women with normal cytology, with the aim of evaluating the possibility of extending vaccination to older females.MethodsThe study was performed in 2010. Women aged 16–26 years with normal cytology were studied. Cervical samples were analyzed to identify the presence of HPV by PCR amplification of a segment of ORF L1 (450 bp). All positive HPV-DNA samples underwent viral genotype analysis by means of a restriction fragment length polymorphism assay.ResultsPositivity for at least one HPV genotype was found in 18.2% of the 566 women recruited: 48.1% in the 16–17 age-class, 15.4 in the 18–20 age-class, 21.9% in the 21–23 age-class, and 15.5% in the 24–26 age-class; 10.1% of women were infected by at least one high-risk HPV genotype. HPV-16 was the most prevalent genotype. Only 4 (0.7%), 4 (0.7%) and 3 (0.5%) women were infected by HPV-18, HPV-6 and HPV-11, respectively. Of the HPV-DNA-positive women, 64.1% presented only one viral genotype, while 24.3% had multiple infections. The HPV genotypes most often involved in multiple infections were high-risk. A high prevalence was noted in the first years of sexual activity (48.1% of HPV-DNA-positive women aged 16–17 years); HPV prevalence subsequently declined and stabilized.The estimate of cumulative proportions of young women free from any HPV infection at each age was evaluated; 93.3% and 97.1% of 26 year-old women proved free from HPV-16 and/or HPV-18 and from HPV-6 and/or HPV-11, respectively.ConclusionsOur findings confirm the crucial importance of conducting studies on women without cytological damage, in order to optimise and up-date preventive interventions against HPV infection, and suggest that vaccinating 26-year-old females at the time of their first pap-test is to be recommend, though this issue should be further explored.

Chlamydia trachomatisprevalence and chlamydial/HPV co-infection among HPV-unvaccinated young Italian females with normal cytology

“…In our previous study 26 566 cervical samples were studied to determine the prevalence of different genotypes of HPV in 16-26-y-old Italian females with normal cytology; the results are reported elsewhere. 26 Briefly, 103 HPV-DNA-positive and 463 HPV-DNA-negative samples were identified; in the present study, these samples were analyzed for Ct. HPV-DNA-positive and -negative groups were comparable in terms of age [19.8 …”

“…26 Briefly, 103 HPV-DNA-positive and 463 HPV-DNA-negative samples were identified; in the present study, these samples were analyzed for Ct. HPV-DNA-positive and -negative groups were comparable in terms of age [19.8 …”

“…18,19 On the other hand, it has been also suggested that the association between Ct and HPV lies only in their shared route of transmission, as both pathogens are markers of sexual risk behaviors. 25 Our previous study 26 revealed an overall HPV prevalence of 18.2% among unvaccinated young females with normal cytological findings and a particularly high prevalence (10.1%) of highrisk HPV genotypes, underlining the need to optimize preventive measures against STIs among healthy young females. Owing to the absence of a national surveillance system and few epidemiological data available, we conducted a study to estimate the prevalence of Ct infection and Ct/HPV co-infection in young asymptomatic women without cervical lesions.…”

Papillomavirus: Viral vectors in the gene therapy and new therapeutic targets

“…Prevalence with predominance of the HPV-16 genotype was found in 18.2% of HPV positives, followed of the HPV-52 type [13].…”

“…Since the implementation of the anti-HPV vaccine in worldwide immunization programs, numerous studies have evaluated the impact of vaccination, and the prevention of thousands of new cases of cervical cancer in the next 50 to 100 years was estimated [12,13,19].…”