Prevalence of human papillomavirus infection in women in some cities and regions of Bulgaria

Abstract

This aim of this study was to evaluate the prevalence of human papillomavirus (HPV) infections among women (aged 15-55 years) in four of the biggest cities and regions in Bulgaria (viz., Sofia, Plovdiv, Varna, and Burgas), as well as in two other smaller cities (viz., Pleven and Vidin). Furthermore, study aimed to identify the prevalence of the 12 high-risk HPV (HR-HPV) genotypes in 2012, and to predict the benefits of a future national vaccination campaign for 12-year-old girls in Bulgaria. This HPV genotypes prevalence study covered 2,331,341 women from these cities and regions, representing 61.7% of the female population of Bulgaria. DNA-sorb-AM nucleic acid extraction kit was used to analyze the HPV status in cervical samples collected during a 4-year period (2008-2011) from 1,120 women aged 15-55 years (divided into four age groups) who had visited 47 gynecological clinics across the study sites. HR-HPV infections were confirmed in 435 (38.8%) of the women examined. The remaining 685 (61.2%) women were found to be HR-HPV negative. The most common genotype in all 435 infected women was HPV16, which was found in 200 women (46%), followed by HPV56 in 86 women (19.8%), HPV31 in 53 women (12.2%), and HPV33 in 50 women (11.5%). This is the first study to have established the prevalence of HR-HPV infections in the larger Bulgarian regions and cities (including the capital), and to have drawn attention to the unusually high proportion of the different HR-HPV genotypes.

Frequency of twelve carcinogenic human papilloma virus types among women from the South Backa region, Vojvodina, Serbia

“…Similar to some European studies, we found that in our region HPV18 was present at a lower percentage and its frequency was five times lower than that of HPV16 (27). Furthermore, if we consider the distribution of HVP genotypes in the Balkan countries (Table 4), it could clearly be seen that the frequency of HPV 18 ranks fourth or fifth in most countries, enabling us to label it as a regional characteristic (16,(28)(29)(30)(31)(32)(33)(34)(35). Although many studies clearly state that the presence of HPV18 increases with the severity of cytological lesions (18,21), we found it in 1.41%, 3.74%, 4.03%, and 3.63% of the NILM, ASCUS, LSIL, and HSIL groups, respectively, with no statistical significance in the differences among them.…”

“…The International Agency for Research on Cancer has classified HPV 16 and 18 as human cervical carcinogens since 1995 (5). By 2011 the group was expanded to include HPV 31,33,35,39,45, 51, 52, 56, 58, and 59 (6). It is estimated that over 50%-80% of sexually active women will be infected with one or more genital HPV types during their lives, with a peak prevalence in young sexually active individuals (7).…”

“…That was the starting point for the development of a new recombinant 9-valent vaccine by Merck, code named V503, that also uses VLPs. V503 contains 5 additional HPV types (31,33,45,52, and 58) to the four HPV types previously included in Gardasil, and has successfully completed several studies. Phase III studies are ongoing (9).…”

Prevalence of human papillomavirus infection in women in Bulgaria: A 2017 update

“…Consequently, the available data are insufficient to assess the epidemiology of HPV among women in Bulgaria . For example, the prevalence of mixed infections by region and age group is unknown, as are changes in incidence, if any, following the introduction of prophylactic vaccines against the most common genotypes in 2012. In this light, a previous study in 2012 examined the distribution and prevalence of 12 high‐risk HPV genotypes in women between 15 and 54 years of age in the four biggest cities and regions of Bulgaria (viz., Sofia, Plovdiv, Varna, and Burgas) and in two smaller communities (viz., Pleven and Vidin).…”

“…In this light, a previous study in 2012 examined the distribution and prevalence of 12 high‐risk HPV genotypes in women between 15 and 54 years of age in the four biggest cities and regions of Bulgaria (viz., Sofia, Plovdiv, Varna, and Burgas) and in two smaller communities (viz., Pleven and Vidin). This survey was also designed to predict the potential benefits of the planned national campaign that began in 2012 to immunize all 12‐year‐old girls against HPV …”