Prevalence and human papillomavirus (HPV) genotype distribution in Suzhou, China

Human papillomavirus (HPV) infection and liquid-based cytologic tests among cervical screening participants in Shannan City, Tibet, China, during 2021-2022

BACKGROUND

Cervical cancer is the most common malignant tumor of the reproductive tract in women and poses a serious threat to their health. Cervical cancer screening is primarily conducted through the detection of HPV or cytological examination. In this study, we analyzed the prevalence, genotyping of HPV, and cervical cytology among women in Shannan city, Tibet, China, between 2021 and 2022, to guide the prevention of cervical cancer among local women. This is the first large-scale cervical cytology screening study conducted in the southern region of the province.

METHODS

Between January 2021 and December 2022, 15,493 women participated in HPV genotype testing, and 16,775 women underwent ThinPrep cytologic tests. HPV prevalence and genotype distribution were analyzed for the entire population. Furthermore, the samples were stratified by age group and altitude to analyze the HPV infection rate and distribution of cervical cytological abnormalities.

RESULTS

The prevalence of HPV in Shannan city was 7.91%, with HPV16 and HPV18 affecting 1.21%. Single infections (95.92%) were more common than multiple infections (4.08%). The overall HPV infection rate peaked in the cohort < 25 years of age (13.25%). Furthermore, HPV infection rates and cervical cell abnormalities varied according to the administrative division in Shannan city, and this difference was attributed to various altitudes.

CONCLUSION

Among HPV carriers, the infection rate peaks in women aged 25 years, after which it declined annually, and the probability of coinfection is relatively low. Additionally, we found that high-altitude areas exhibited elevated HPV prevalence but fewer cervical abnormalities, suggesting complex environmental, genetic, and cultural influences on infection and disease progression. Based on these data, effective recommendations can be made for cervical cancer screening and HPV prevention in local communities.

Epidemiological Analysis of HPV Infection in Zhangjiagang, Southern Jiangsu Province of China: A Cross-Sectional Study

An examination of the fluctuating rates of the human papillomavirus (HPV) prevalence and the allocation of various genotypes could assist in the implementation of targeted strategies for the prevention and treatment of cervical cancer. The present study was aimed at evaluating the prevalence of HPV and genotype distribution among female populations in Zhangjiagang, Jiangsu Province, China. A total of 62,036 patients from the Affiliated Zhangjiagang Hospital of Soochow University provided clinical specimens between January 2022 and August 2023, and 12,144 women were infected with HPV, with an overall positive rate of 19.58%. The most prevalent HR-HPV types were HPV52 (4.14%), HPV16 (2.44%), HPV53 (2.37%), HPV58 (2.37%), and HPV56 (1.50%). In the low-risk group, the highest infection rate was HPV81 (1.76%). The prevalence of HPV infection showed a "U"-shaped curve. In addition to the adolescent group, other age groups are mainly single infection. And the gynecology clinic group had much higher rates of HPV positivity compared to the physical examination group (p < 0.001). Our study suggests that HPV screening and vaccination in young women are highly necessary, and 9-valent HPV vaccine is recommended for regular immunization in Zhangjiagang city.

Prevalence of Human Papilloma Virus in Coquimbo, Chile

BACKGROUND

Human papillomavirus (HPV) is the main pathogen responsible of cervical cancer. The characterization of HPV genotypes in preneoplastic lesions and cervical cancer could establishes the effectiveness of the vaccination plan in the Chilean population. The aim of this study was to determine the frequency of HPV in women in the Coquimbo region.

METHODS

A total of 1235 cervical samples from women aged 20-64 years old who attended gynecological check-ups from April 2023 to July 2024 were analyzed to detect HPV genotypes using qPCR.

RESULTS

The overall prevalence rate of HPV infection was 26.56 %, while the prevalence of HR-HPV in age groups G1 (20-29 years) and G2 (30-64 years) was 47.69 % and 24.07 %, respectively. The most prevalent genotypes of HPV infection among our entire population were HPV16, HPV51 and HPV 31. Single infection (74.70 %) was the main pattern of HPV infection observed in the entire group, followed by double infection (16.46 %) and multiple infection (8.84 %), which was similar in Group 2, with percentiles of 76.07 %, 15.79 % and 7.14 %, respectively. However, in Group 1 a higher frequency of multiple HPV infections was observed, with 16.13 %.

CONCLUSION

This HPV prevalence infections among women in the Coquimbo region appears to be higher than the reported in Chile. In the rest of country, HPV prevalence is likely underestimated. Molecular detection of 14 HR-HPV genotypes is important because it will not only help women avoid cervical cancer but could also inform the introduction of new vaccines targeting a broader spectrum of HR-HPV.

Investigation and analysis of female HPV infection and genotype distribution in Xuhui District, Shanghai

OBJECTIVE

In China, Cervical cancer is one of the common malignant tumors in females, and high-risk human papillomavirus (HR-HPV) infection is one of its main causative factors. However, human papillomavirus (HPV) infection rates may vary significantly among patients of different ages and HPV subtypes. This study aims to provide insights into developing cervical cancer screening strategies and selecting HPV vaccine antigen targets in the area.

METHODS

A retrospective analysis was conducted on the HPV testing results of 47,423 women from January 2017 to April 2023 at the Clinical Laboratory of the Eighth People's Hospital in Shanghai. HPV DNA genotyping was performed using real-time quantitative polymerase chain reaction (PCR) in the molecular laboratory. Statistical analysis was carried out using GraphPad Prism 8.0.1 software. Binomial distribution analysis was used to calculate the 95% confidence intervals (95% CI), and the chi-square test was employed to compare categorical variables among different age groups, with a p-value of less than 0.05 indicating statistical significance.

RESULTS

Among the 47,423 cervical HPV DNA test results, the overall infection rate was 18.9%, with single infections accounting for 13.93%, dual infections for 3.47%, and multiple infections for 1.5%. The age-specific prevalence of HPV infection exhibited a "U"-shaped curve, with the highest infection rates observed in the age groups under 30 and between 50 and 59 years. The five most common HR-HPV subtypes in Xuhui District were types 16, 39, 51, 52, 56, and 58 (accounting for 10.3%, 7%, 8%, 20.3%, 6%, and 12%, respectively), with type 52 showing the highest infection rate. The prevalence of moderate/severe HPV infection rates in the HPV 59, HPV 33, and HPV 35 gene subtypes increased over time, highlighting the importance of monitoring these subtypes.

CONCLUSION

This study identified the primary HR-HPV genotypes prevalent among females in Xuhui District, Shanghai, and explored correlations between age, genotype, and HPV infection rates. While the findings provide a basis for recommending HPV screening for younger and older age groups, further studies integrating clinical outcomes such as cytological and pathological results are necessary to substantiate these conclusions and refine screening strategies. Due to variations in HPV trends globally and regional differences in genotypes, epidemiological analysis of HPV can accurately and visually reflect the distribution of specific HPV genotypes in a particular area, thereby aiding in the development of regional cervical cancer screening strategies and the selection of HPV vaccine antigen targets.

Epidemiological study of HPV infection in 24,588 rural women in Luonan, China

Cervical cancer is a significant public health issue for women, with human papillomavirus (HPV) infection rates exhibiting regional variations throughout China. This study examined data from a cohort of 24,588 rural women who engaged in cervical cancer screening in Luonan County from 2021 to 2023, utilizing high-risk HPV (hrHPV) testing methodologies. The findings revealed an overall HPV positivity rate of 14.18 %, with hrHPV positivity rates of 13.99 % in 2021, 12.97 % in 2022, and 15.32 % in 2023. Infection rates increased with age, showing significant differences among age groups. Types 52, 16, and 58 were the most prevalent hrHPV types. Single-type infections were more common than multiple infections, with prevalent combinations such as HPV16 + HPV52, HPV52 + HPV58, and HPV51 + HPV16. The results highlight the imperative for improved screening, especially for women aged 60 to 64 residing in rural areas, and emphasize the importance of HPV vaccination and targeted screening for the prevention and eventual eradication of cervical cancer.

Opportunities and challenges for human papillomavirus vaccination in China

Current estimates of the HPV infection rate in China vary by geographic region (9.6-23.6%), with two age peaks in prevalence in women ≤20-25 years of age and 50-60 years of age. HPV-16, 52 and 58 are the most commonly-detected HPV genotypes in the Chinese population. In China, five HPV vaccines are licensed and several others are undergoing clinical trials. Multiple RCTs have shown the efficacy and safety of the bvHPV (Cervarix), Escherichia coli-produced bvHPV (Cecolin), Pichia pastoris-produced bvHPV (Walrinvax), qvHPV (Gardasil) and 9vHPV (Gardasil-9) vaccines in Chinese populations, including two studies showing long-term efficacy (≥8 years) for the bvHPV and qvHPV vaccines. Real-world data from China are scarce. Although modeling studies in China show HPV vaccination is cost-effective, uptake and population coverage are relatively low. Various policies have been implemented to raise awareness and increase vaccine coverage, with the long-term aim of eliminating cervical cancer in China.

Age-specific 3-year risk of cervical precancer among HPV-positive women attending screening: a post hoc analysis from a retrospective cohort

This post hoc analysis explored the age-specific risk of cervical precancer in women infected with human papillomavirus (HPV), using data from a cohort of 7263 participants aged 21-71years undergoing cervical screening. We found a slightly varied prevalence of high-risk HPV (hrHPV) in different age, with highest in women under 30 years old (9.28% for 13 hrHPVs tested by HC2-HPV, 10.82% for 14 hrHPVs tested by DH3-HPV). However, the prevalence of cytology abnormalities peaked in age 30-39 years (~ 3.6%). A total of 5840 women completed 3-year follow-up. Among them, 558 were positive for HC2 assay and 583 were positive for DH3-HPV at baseline. Of note, the 3-year cumulative risks for cervical intraepithelial neoplasia grade 2+ (CIN2+) or grade 3+ (CIN3+) in women infected with high-risk HPV did not increase with age but declined (e.g., 41.67%, 27.78%, 26.42%, 15.98%, and 18% for CIN2 + risk in HC2-positive women at year 25-29, year 30-39, year 40-49, year 50-59, and year 60-71, respectively). If stratified by the median age, younger women (25-48 years) positive with HC2-HPV at baseline had a higher 3-year CIN2+/CIN3 + risk than older women (49-71 years) [26.55% (95%CI = 21.8-31.92%) vs. 18.28% (95%CI = 14.11-23.34%), P = 0.019; 15.52% (95%CI = 11.81-20.14%) vs. 9.7% (95%CI = 6.71-13.83%), P = 0.039]. Similarly, for women positive with DH3-HPV at baseline, younger group had a higher 3-year CIN2+/CIN3 + risk than older group [26.44% (95%CI = 21.73-31.75%) vs. 17.01% (95%CI = 13.11-21.78%), P = 0.006; 15.25% (95%CI = 11.6-19.8%) vs. 9.03% (95%CI = 6.24-12.9%), P = 0.021]. These findings indicate the potential value of age-specific risk assessment in cervical cancer screening.

Prevalence and genotype distribution of human papillomavirus infection among 66000 women from 2014 to 2023 in the plateau region of Southwest China

BACKGROUND

Persistent infection with high-risk human papillomavirus (HR-HPV) plays a key role in the onset of cervical cancer. This study was designed to examine the epidemiological trends and genotype distribution of HPV from 2014 to 2023 in the plateau region of Southwest China.

METHODS

The findings could offer valuable insights for clinical screening of cervical cancer and the formulation of HPV vaccination policies. This retrospective study analyzed 66,000 women who received HPV-DNA testing at the First People's Hospital of Qujing, Yunnan, China, between 2014 and 2023. The cohort consisted of 33,512 outpatients, 3,816 inpatients, and 28,672 individuals undergoing health examinations. Cervical cells were collected for DNA extraction, and PCR amplification along with Luminex xMAP technology were used to detect 27 HPV genotypes. The data analysis was conducted using GraphPad Prism and IBM SPSS Statistics 27 software.

RESULTS

The overall HPV infection rate at the First People's Hospital of Qujing declined from 24.92% in 2014 to 16.29% in 2023, averaging 16.02%. Specific infection rates were 18.50% among outpatients, 12.97% among inpatients, and 13.53% for health examination attendees. The predominant high-risk HPV genotypes identified were HPV52 (2.61%), HPV16 (2.06%), HPV58 (1.81%), HPV53 (1.55%), and HPV39 (1.09%). Meanwhile, the most frequent low-risk HPV genotypes were HPV6 (1.30%), HPV61 (1.21%), and HPV11 (0.85%). In HPV-positive cases, the distribution of single, double, triple, and quadruple or more infections were 79.90%, 15.17%, 3.59%, and 1.33%, respectively. The proportions of pure LR-HPV, pure HR-HPV, and mixed infections were 22.16%, 67.82%, and 10.02%, respectively. Age-specific analysis revealed a bimodal distribution of HPV infection, with the infection rate rapidly decreasing from 44.02% in the ≤ 19 age group to 19.55% in the 20-29 age group and 13.84% in the 30-39 age group, followed by a gradual increase to 14.64% in the 40-49 age group, 16.65% in the 50-59 age group, and 22.98% in the ≥ 60 age group. The coverage rates of the three available vaccines are all below 50%. The results of this study indicated a declining trend in HPV prevalence in the plateau region of Southwest China over the period from 2014 to 2023, especially in the reduction of genotypes targeted by vaccines.

CONCLUSION

There were significant variations in the genotypes prevalent among different age groups, years, and patient sources within the same region. The underwhelming vaccination rates emphasize the critical need for developing either a multivalent vaccine or a personalized vaccine that targets the HPV genotypes common in the Chinese population. Furthermore, vaccinating adolescents to curb HPV infection and ensuring regular cervical cancer screenings for postmenopausal women are crucial steps.

Prevalence and genotype distribution of HPV combined with cervical pathological results in women from Sichuan, China: A cross-sectional study based on post-vaccination period 2019 to 2023

BACKGROUND

Human papillomavirus (HPV) screening and vaccination exert efficacy in controlling the progression of cervical cancer. Thus, examinations into HPV prevalence, age-stratified specificity, genotype distribution, and their correlation with pathological outcomes can furnish robust evidence for customizing high-quality population screening and management.

METHODS

A cohort of 17,923 women attending clinics in the Jintang area, Sichuan, from January 2019 through August 2023 were enrolled in the study. Genotyping of HPV was conducted using real-time polymerase chain reaction (RT-PCR). The epidemiology and the relationship between HPV infection and histologic/cytologic abnormalities were subjected to analysis.

RESULTS

HPV infection was identified in 4387 women. The outpatient group exhibited a significantly higher HPV infection rate compared to the healthy examination group (26.5% vs. 17.5%, p < 0.05). The distribution of infection rates across different age groups exhibited a U-shaped pattern, with the highest infection rate in the group ≤20 years of age, succeeded by those >60 years of age. The 31-40 age group demonstrated the lowest prevalence of infection, but upon infection, its prevalence of the precancerous lesion CIN2-3 reached a maximum of 29.0%, constituting a novel finding. The most prevalent genotype was HPV52, followed by HPV16, 58, 53, 68, and 18. In the cytologic and histologic abnormalities group, the most common types were HPV52, 16, and 58. HPV16 predominantly appeared in high-grade intraepithelial neoplasia and carcinoma in situ, constituting over 60% of cases. While HPV type 52 was not individually detected in cervical cancer cases. And some other non-vaccine-covered HPV subtypes also showed high prevalence in Sichuan. The single infection rates of NH9-HPV (high-risk HPV subtypes covered by the non-nine-valent vaccine) in CIN2-3 and cervical cancer patients were 6.5% and 2.6%, respectively. Among them, HPV51, HPV53, HPV59, and HPV35 exhibited a significant preponderance, which even higher than HPV45 and HPV31 covered by the nine-valent vaccine types. And in NL9-HPV (low-risk HPV subtypes covered by the non-nine-valent vaccine), HPV42 accounted for the highest percentage in CIN2-3. A similar decreasing trend was observed in annual infection rates in the healthy examination population and in the 31-40 and 51-60 age groups, while the ≤20 age group showed an increase. Regarding type-specificity, HPV16 and HPV58 exhibited the most rapid declines.

CONCLUSION

This study furnishes the latest insights into the characteristics of HPV infection rate, age distribution, and genotype prevalence in Sichuan.

The cervical cancer related distribution, coinfection and risk of 15 HPV types in Baoan, Shenzhen, in 2017-2023

Cervical cancer is one of the most common malignant tumours. Human papillomavirus (HPV) infection is the main cause of this cancer so that it could be prevented by screening and early treatment. Developing reginal screen protocols of maximum public health efficacy requires in-depth understandings of local HPV distribution and consequential cancer risks. Therefore, test results of HPV genotyping, cytology testing (TCT) and colposcopy inspection with biopsy were collected in this retrospective research. Data included by this research involved 63,906 women received screen related tests from Shenzhen Baoan Shiyan People's Hospital and the subsidiary institutes between 2017.01 and 2023.05. 10,238 colposcopies were performed in this period collecting 8,716 samples and 814 high-grade CIN were discovered. Within the 763 high-grade CIN cases with both TCT and HPV testing results, 232 were tested cytologically normal but only 30 were negative in HPV test. Besides, the rates of high-grade CIN observed in coinfection were all lower than the estimated rates generated from related single infection. HPV 52, 58 and 16 were found to be the most common types in Baoan, Shenzhen. The result also suggested that HPV coinfections should not increase risk for cervical cancers.

Orogenital Human Papillomavirus Infection and Vaccines: A Survey of High- and Low-Risk Genotypes Not Included in Vaccines

Knowledge of human papillomavirus transmission from the genital tract to the oral mucosa remains unsatisfactory, with poor and often inconsistent literature results. The increase in HPV-associated oral malignancies prompts further analysis of the simultaneous detection of the virus in the two anatomical areas and on the identification of genotypes to be included in future vaccines. Therefore, in this retrospective study, we evaluated orogenital HPV concurrence, hrHPV, lrHPV and type-concordance in 337 samples, as well as the prevalence of the most common genotypes not included in HPV vaccines. Concurrence was found in 12.5% (31/248) of cases, hr-concordance in 61.3% (19/31) and lr-concordance in 12.9% (4/31). Finally, type-concordance was found in 32.3% (10/31) of concurrent infections. Regarding the identification of non-vaccine genotypes, the significantly prevalent genotypes in the anogenital area were HPV66 (12.6%, p < 0.0001), HPV53 (11.1%, p < 0.0001), HPV51 (8.7%, p < 0.0001), HPV42 (8.2%, p < 0.0001) and HPV68 (5.6%, p = 0.0034) in women and HPV66 (14.6%, p = 0.0058), HPV42 (12.2%, p = 0.0428), HPV51 (12.2%, p = 0.0428), HPV53 (12.2%, p = 0.0428), HPV70 (12.2%, p = 0.0428) and HPV73 (12.2%, p = 0.0428) in men. Considering the results of our study, we recommend including the high-risk genotypes HPV51, HPV68, HPV53 and HPV66 in future HPV vaccine formulations.