Carcinogenic ability quantification of human papilloma virus subtypes in eastern China

Age-specific prevalence and genotype distribution of human papillomavirus in women from Northwest China

BACKGROUND

Human papillomavirus (HPV) is the leading cause of cervical cancer with more than 200 genotypes. Different genotypes have different potentials in causing premalignant lesions and cervical cancers. In this study, we investigated the age-specific prevalence and genotype distribution of HPV genotypes in Northwest China.

MATERIALS AND METHODS

We recruited 145,918 unvaccinated women from Northwest China for population-based HPV DNA screening test during June 2015 to December 2020. And a lab-based test was performed for each volunteer by flow fluorescent technology to identify the genotypes of HPV.

RESULTS

The overall infection rate of HPV was 22.97%. With the participants divided into 12 groups according to age, a bimodal curve of infection rate was obtained. And the two peaks appeared in the younger than 20 group and 61-65 group, respectively. The five most common HPV genotypes included HPV 16, 58, 52, 53 and 61 in all participants, which were in descending order of frequency. Among women younger than 25 years old, HPV 6 and 11 were more common and even higher than some genotypes mentioned above. Among women older than 65 years old, HPV 18 and 66 were more common than or as high as the six most common genotypes in all populations. Additionally, the distribution of single and multiple infections in each age group was also different.

CONCLUSION

The baseline prevalence and genotype distribution of HPV in Northwest China was uncovered for the first time. Age was related to the epidemiology of different HPV genotypes. All the results would be of great significance for future healthcare services.

Characteristics of women infected with human papillomavirus in a tertiary hospital in Beijing China, 2014-2018

BACKGROUND

Human papillomavirus (HPV) infection is the main cause of precancerous lesions and cervical cancer in women. In order to determine the epidemiological characteristics as well as the relationship between the HPV genotype and cytology test results among women in Beijing, China, we retrospectively collected and analyzed the data from a tertiary hospital in Beijing, China.

METHODS

A total of 21,239 women visited the China-Japan Friendship Hospital between 2014 and 2018 and their cervical exfoliations were collected. Thirteen HPV subtypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68) were examined and ThinPrep cytological test (TCT) was performed.

RESULTS

Among all cases, 4473 (21.06%) women were infected with HPV. HPV52 (4.64%), HPV16 (4.44%) and HPV58 (4.28%) had higher prevalence. Single-type infection (77.26%) was more common than multiple-type infection (22.74%). Single-type infection was more frequently seen in women aged 50-60 years (17.17%), and multiple-type infection was more common in those aged < 30 years (7.88%). Significant differences in secular trends from 2014 to 2018 were observed for subtypes HPV39, 51, 52 and 58. HPV positive rates of women aged < 30 and 30-40 years changed significantly along with the time period, and the TCT positive rates of women aged 30-40, 40-50, 50-60 and >  60 years also showed significant differences from 2014 to 2018. In addition, 1746 (8.22%) women were TCT positive, of whom, 858 (4.04%), 561 (2.64%) and 327 (1.54%) had atypical squamous cells (ASCs), low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSILs), respectively. Among four types of cytological lesions, the HPV infection rates were 16.76, 66.08, 63.99 and 85.32% in those negative for intraepithelial lesions or malignancy (NILM), ASC, LSIL and HSIL, respectively.

CONCLUSIONS

HPV52, 16 and 58 are the most common infection subtypes in this study and among four types of cytological lesions, HSILs has the highest HPV prevalence. Significant differences in secular trends are observed for different subtypes in recent 5 years. The results on HPV genotype-specific prevalence should be considered when the HPV vaccine program is implemented in Beijing area.

Screening for HPV infection in exfoliated cervical cells of women from different ethnic groups in Yili, Xinjiang, China

We investigated the infection status and genotype distribution of human papillomavirus (HPV) in women of different ages and various ethnic groups in the Yili region, Xinjiang, China. We checked the HPV genotypes of 3,445 samples of exfoliated cervical cells using the PCR–reverse dot blot method. The total infection rate of HPV was 25.60% (882/3,445). The ethnic stratification showed that the infection rates were 22.87% (196/857) in Uygur, 21.55% (122/566) in Kazak, and 27.89% (564/2,022) in Han individuals. The most prevalent high-risk genotypes were HPV16, HPV52, and HPV53 in Uygur and Kazak and HPV16, HPV52, and HPV58 in Han ethnic groups. The age stratification showed that the infection rates in Han, Uygur, and Kazak women were up to 40.9% (61/149) in those aged 26–30 years, 41.5% (22/53) in those over 61 years old, and 30.2% (29/96) in those 46–50 years old, respectively. Therefore, HPV infection and HPV genotype distribution varied among the different age groups of the three ethnic groups.

HPV prevalence and genotype distribution among women in Shandong Province, China: Analysis of 94,489 HPV genotyping results from Shandong's largest independent pathology laboratory

Background

Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shandong Province, China. Therefore, we investigated the recent HPV prevalence and genotype distribution among females in Shandong and aimed to provide comprehensive data to guide HPV-based cervical cancer screening and HPV vaccination for this population of Chinese women.

Methods

HPV testing results of 94,489 females were retrospectively reviewed and extracted from the database of Jinan KingMed Diagnostics, the largest independent pathology laboratory in Shandong Province, China. HPV was detected by a HPV genotyping panel from January 2011 to June 2017. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed.

Results

A total of 26,839 cases (28.4%) were HPV-positive, with 4.3% positive for low- or undetermined-risk HPV (lr-/urHPV)-only, 18.1% positive for high-risk HPV (hrHPV)-only, and 6.1% positive for mixed lr-/urHPV and hrHPV infections. Single HPV infections accounted for 62.8%, while the rest were multiple HPV infections of two or more genotypes. HPV16 (5.8%), HPV52 (5.1%), HPV58 (3.5%), HPV51 (2.6%), and HPV56 (2.3%) were the five most common hrHPV genotypes; while HPV81 (2.8%), HPV53 (2.8%), and HPV6 (2.3%) were the three most common lr-/urHPV genotypes. HPV18 (1.7%) was only the ninth most common hrHPV genotype. HPV16 but not HPV52 was more common in single infections than in multiple infections. The distribution of both mixed lr-/urHPV and hrHPV as well as overall HPV infections demonstrated a bimodal pattern across age groups, of which the first peak appeared in the younger group and the second peak was found in older women. A similar age-specific distribution was observed in multiple infections of three or more subtypes as well. Moreover, the proportion of mixed lr-/urHPV and hrHPV infection significantly increased, while those of lr-/urHPV-only and hrHPV-only infections declined as the number of co-infections increased during the study period.

Conclusion

This large daily clinical practice report shows that HPV prevalence and genotype distribution are different in this population, who had limited cervical cancer screening service, compared to those in developed countries. Therefore, different strategies should be developed for HPV-based cervical cancer screening and vaccine-based HPV prevention in Shandong Province.

Prevalence of human papillomavirus genotypes and relative risk of cervical cancer in China: a systematic review and meta-analysis

High-risk HPV (hrHPV) is related to cervical carcinogenesis, although clinical data comparing the natural history and carcinogenic potential of type-specific HPV remain limited. Furthermore, the nationwide prevalence rates of overall and type-specific HPV among women with cervical precancerous lesions and cancer have not been reported. Here, a meta-analysis was performed for type-specific HPV distribution among 30,165 HPV-positive women, including 12,094 invasive cervical cancers (ICCs), 10,026 cervical intraepithelial neoplasia grade 2/3 (CIN2/3), 3246 CIN1, and 4799 normal cervices from 45 PCR-based studies. We found that HPV16 was the most common hrHPV type involved in cervical disease. The HPV16 positivity rate varied little across normal (22.7%) and CIN1 individuals (23.6%) but increased through the CIN2 (37.6%) and CIN3 patients (51.9%) to 65.6% in ICC cases. HPV16, 18, 35, 39, 45, and 59 were more frequent in ICC than CIN3, with ICC:CIN3 ratios ranging from 2.3 for HPV18 to 1.1 for HPV35/45. HPV31, 33, 52, and 58 were more frequent in CIN3 compared with normal cervices but less common in ICC compared with CIN3 (ICC:CIN3 ratios ranging from 0.6 for HPV58 and 0.4 for HPV52). The ICC:normal ratios were particularly high for HPV18, 52 and 58 in West China (4.1, 3.9 and 2.9, respectively) and for HPV45 and 59 in North China (1.6 and 1.1, respectively). In summary, this study is the most comprehensive analysis of type-specific HPV distribution in cervical carcinogenesis and could be valuable for HPV-based cervical cancer screening strategies and vaccination policies in China.

Anal HPV/HIV co-infection among Men Who Have Sex with Men: a cross-sectional survey from three cities in China

Anal human papillomavirus (HPV) infection, which is linked to anal warts and anal cancer, is common among men who have sex with men (MSM), especially among those HIV positives. MSM aged 18 years or older were recruited from mainland China. Blood and anal cytologic samples were collected for HIV-1 serological test and HPV genotyping. A total of 889 eligible participations were included. The genotyping results of HPV were available for 822 participants (92.46%), 65.32% of which were positive for the targeted 37 HPV types. Prevalence of infection with any type of HPV was higher among HIV-infected participants (82.69%) as compared to HIV-uninfected participants (62.81%) (p < 0.01). HPV06 (15.45%), HPV18(13.50%), HPV16 (11.44%), and HPV11 (10.71%) were the most frequent types identified in the study population. Ever had paid sex with man was found to be independent predictor for HPV positivity with an adjusted odds ratios (OR) of 2.34 (1.16–4.74). Anal HPV positivity was observed to be independently associated with HIV infection with an adjusted OR of 3.03 (1.76–5.21) in the study population. In conclusion, the prevalence of anal HPV infection was observed to be common among MSM from mainland China, and it was significantly associated with the status of HIV infection.