Prevalence and Genotype Distribution of Human Papillomavirus Among Attendees at a Sexually Transmitted Diseases Clinic in Urban Tianjin, China

Characterization of human papillomavirus genotypes infections in patients with cervical lesions and cervical cancer in Urumqi, Xinjiang from 2016 to 2023

BACKGROUND

The persistence of high-risk human papillomavirus (HPV) infection is well-established as a key etiological factor in the progression to cervical intraepithelial neoplasia (CIN) and cervical cancer (CC). This study aims to investigate the clinical and epidemiological characteristics associated with HR-HPV infections diagnosed in conjunction with cervical intraepithelial lesions in Urumqi, Xinjiang.

METHODS

Between 2016 and 2023, we collected clinical data from 4,389 patients with cervical lesions who underwent colposcopic histopathological examination at the People's Hospital of Xinjiang Uygur Autonomous Region. Cervical samples were obtained for HPV DNA genotyping and cytological analysis. Patients presenting with cervical abnormalities or abnormal cytology results subsequently underwent cervical biopsy.

RESULTS

The prevalence of HPV infection among 4,389 patients with cervical lesions were found to be 98.95% (4,345/4,389). Specifically, the prevalence of HPV types 16 and 18 were 78.87% (1,314/1,666). The five most common genotypes identified were HPV types 16, 52, 58, 31, and 33, with infection rates of 34.57%, 19.54%, 12.45%, 8.98%, and 7.66%, respectively. Among the patients with cervical lesions, cervical inflammation was observed in 522 individuals (11.90%), while the distribution of cervical intraepithelial neoplasia (CIN) was as follows: CIN I in 644 patients (14.67%), CIN II in 1,067 patients (24.31%), CIN III in 1,041 patients (23.72%), and CC in 1,115 patients (25.40%). The distribution of patients in the CC group was most prevalent among those aged ≥ 60 years (47.99%, 322/671). A high prevalence was also observed in the 30~39 year age group within the CIN III group (29.47%, 275/933). Han and Uygur patients accounted for 85.90% of cervical lesion cases (3,770/4,389). Hui patients were predominantly identified within the CIN II group (34.12%), whereas Uighur patients were most frequently observed in CC group (36.60%) (P < 0.005).

CONCLUSIONS

Patients with cervical lesions had high HPV prevalence in Urumqi, Xinjiang. The five most prevalent HPV types identified in this population are HPV 16, 52, 58, 31, and 33. Epidemiological studies focusing on high-risk HPV types hold significant clinical implications, particularly in informing and guiding HPV vaccination strategies.

Prevalence of Human Papillomavirus and Genotype Distribution in Chinese Men: A Systematic Review and Meta-Analysis

BACKGROUND

Human papillomavirus (HPV) vaccination represents a cost-effective strategy for preventing HPV-related diseases across genders. However, the HPV vaccine has not been approved for mainland Chinese males, and the comprehensive epidemiological landscape of HPV among Chinese males from mainland China is limited.

METHODS

This study aimed to address this gap by examining HPV infection data in Chinese males from January 2012 to September 2024. Four English databases (Web of Science, Embase, Medline, and Cochrane Library) and four Chinese databases (CNKI, VIP, Wanfang, and SinoMed) were systematically reviewed. Random effect models assessed pooled HPV prevalence, and subgroup analyses were conducted based on population (outpatients vs. health checkups). Genotype-specific HPV positivity was calculated.

RESULTS

A total of 296 studies were included, encompassing 199,233 outpatients and 16,452 health checkups. HPV prevalence was 52.45% among outpatients, with the most prevalent subtypes being HPV 6 (19.06%), 11 (13.71%), and 16 (8.29%). Among health checkups, HPV prevalence was 7.89%, with the highest prevalence subtypes being HPV 16 (3.66%), 52 (1.37%), and 58 (1.19%). Among male patients diagnosed with cancer, HPV 16 (18.50%) and 18 (5.33%) were the most common subtypes, and HPV prevalence was 82.11% among the HIV-positive MSM population.

CONCLUSION

The high prevalence of HPV among Chinese males, particularly among outpatients and the HIV-positive MSM population, underscores the urgent need for targeted prevention strategies. The common subtypes identified in this analysis highlight the potential benefits of introducing HPV prophylactic vaccines to Chinese males, which could significantly reduce the burden of HPV-related diseases across the population.

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.

Association between human papillomaviruses, metabolic syndrome, and all-cause death; analysis of the U.S. NHANES 2003-2004 to 2015-2016

INTRODUCTION

Human papillomavirus (HPV) is the most common sexually transmitted infection, attributed to 4.5% of all cancers worldwide. Co-infection with the metabolic syndrome (MetS), a common cluster of cardiometabolic risk factors, has been shown to increase the persistence of HPV. The purpose of this study was to estimate the association between HPV and MetS on mortality risk.

METHODS

Data for the current study was drawn from seven consecutive cycles (2003-2004 to 2015-2016) of the U.S. NHANES. The final analytic sample consisted of 5,101 individuals aged 18-65y with HPV and MetS information with follow-up to Dec. 31st, 2019. Baseline HPV status was assessed by either vaginal swab, penile swab or oral rinse and used to classify participants as: no HPV (n = 1,619), low (n = 1,138), probable (n = 672), and high-risk (n = 1,672; 22% type 16, and 10% type 18) HPV using IARC criteria. MetS was assessed by the Harmonized criteria.

RESULTS

The average follow-up was 9.4 y with 240 all-cause deaths (no HPV: n = 46 deaths; low-risk: n = 60 deaths; probable: n = 37 deaths, and; high-risk: n = 97 deaths). HPV status alone revealed no associations with mortality in fully adjusted models. Cross-classification into discrete MetS/HPV strata yielded an increased risk of mortality in females with high-risk HPV/MetS relative to the no MetS/no HPV group.

CONCLUSIONS

In this study, low, probable, and high-risk HPV and MetS were differentially related to mortality risk in men and women. Further work is necessary to separate the temporal, age, vaccination, and sex effects of HPV diagnosis in these relationships using prospective studies with detailed histories of HPV infection and persistence.

Human papillomavirus prevalence and genotype distribution in Liaocheng men between 2016 and 2022

Human papillomavirus (HPV) infection can lead to HPV-related cancer in men, including the anus, penile, and oropharyngeal cancers and precancerous lesions. This study retrospectively investigated HPV prevalence and genotype distribution in Liaocheng men between 2016 and 2022. The total HPV positive rate was 64.87% (2388/3681, 95% confidence interval [CI]: 63.32%-66.40%), where high risk (HR)-HPV and low risk (LR)-HPV accounted for 42.49% (1564/3681, 95% CI: 40.90%-44.09%) and 69.71% (2566/3681, 95% CI: 68.20%-71.17%), respectively. The mixed HPV infection rate of two and more genotypes was 35.72%. The infection rate of HR-HPV increased with the number of positive cases annually from 2016 (16.91%) to 2022 (46.59%). The most common HR-HPV genotypes were HPV16 (11.60%), HPV52 (6.95%), and HPV59 (6.28%), whereas the least common HR-HPV was HPV26. The most common LR-HPV genotypes were HPV6 (56.99%), HPV11 (23.79%), and HPV43 (6.37%). The 9 v HPV vaccine preventable for LR-HPV and HR-HPV accounted for 80.78% and 30.40%, respectively, in this study. Most HPV-positive patients aged 1-86 were in the 30-39 age group. This study confirmed that HPV prevalence in Liaocheng men was common and diverse. HPV16, HPV52, and HPV59 are widely distributed in Liaocheng men, and the male HR-HPV infection rate remained high in this region. Regarding public health and cancer prevention, it is recommended and effective to include the HPV vaccination in the national vaccination program for men.

Detection of high-risk human papillomavirus infected cervical biopsies samples by immunohistochemical expression of the p16 tumor marker

Cervical cancer is the fourth most common type of cancer in women worldwide. It is widely accepted that the main cause of cervical cancer, especially in underdeveloped countries like Pakistan, is the infection caused by the human papillomavirus (HPV). The current screening and diagnostic methods face several challenges in accurately detecting the various types of lesions caused by HPV. Therefore, the present study was conducted to assess the effectiveness of p16 immunohistochemistry (IHC) analysis as a diagnostic method in samples of cervical biopsies. One hundred cervical biopsy samples were obtained from female patients across various age groups (> 20- ≤ 30, > 31- ≤ 40, > 41- ≤ 50, > 51- ≤ 60 years). These samples were subsequently prepared for subsequent examination. All samples were analyzed using automated tissue processing followed by Hematoxylin and Eosin (H & E) staining, and p16 IHC tumour marker staining. The H & E slides showed changes in normal cervical tissues, while four cervical abnormalities were identified statistically significant using p16 marker including chronic cervicitis, nabothian cyst formation, cervical intraepithelial neoplasia, and cervical cancers (P value 0.014). Furthermore, among females of different age groups (> 31- ≤ 40, > 41- ≤ 50, > 51- ≤ 60 years) were found statistically significant suffering from cervical cancer (P value 0.04), HPV with cervical cancer (P value 0.01), HPV with cervical intraepithelial neoplasia (P value 0.01). Based on the available data, it can be inferred that the incorporation of the p16 tumor marker may be a valuable method for detecting high-risk HPV in cervical biopsies samples.

The impact of the COVID-19 pandemic on the prevalence and genotype distribution of HPV infection in Beijing, China

Human papillomavirus (HPV) is one of the most common sexually transmitted infections nationwide. The COVID-19 pandemic has greatly influenced on the HPV prevention project. The objective of this study was to examine the influence of the pandemic on HPV prevalence and genotype distribution in Beijing, China. A total of 44 401 genital swabs were obtained from outpatients at Peking Union Medical College Hospital during two distinct periods: the prepandemic stage from January 2017 to December 2019 and the pandemic stage from January 2020 to December 2022. During the prepandemic and pandemic stages, a total of 33 531 and 10 870 swabs were respectively collected. Fifteen high-risk HPV (HR-HPV) DNA type and a combination of two low-risk (LR-HPV) types (6/11) of genital swabs were detected to compare the HPV infection rates and genotype distributions in two stages. The results showed that the pandemic period witnessed a decrease in the overall HPV infection rate from 33.43% (11 245/33 531) to 29.43% (5527/18 780) compared to the prepandemic. There were statistically significant differences in infection rates between females and males (p < 0.05). Single infection was the predominant type while multiple infection was more prevalent in males than females in both prepandemic and pandemic periods. HR-HPV infection constituted the majority of infections and cannot be disregarded. The distribution of HR-HPV genotypes exhibited little variation before and after the outbreak, but there were some differences between females and males. HPV 16, 52, 58, 56, and 66 were the most commonly detected genotypes in females, whereas HPV 16, 52, 51, 58, and 18 were frequently detected in males. Additionally, HPV 6/11 exhibited a higher prevalence in males than in females. Notably, the age group of 31-40 years old exhibited the highest prevalence of HPV and the lowest infection rate was detected among individuals aged ≤20 years (p < 0.05), which remained relatively consistent before and during the pandemic. These findings underscore the importance of monitoring the trend of HPV epidemic and offer valuable insights for the prevention, treatment, and scientific investigation of HPV in the post-COVID-19 era.

Prevalence and genotype distribution of human papillomavirus infections in Beijing, China between 2016 and 2020

BACKGROUND

Certain types of human papillomavirus (HPV) induce long-lasting infections that cause cervical cancer. This study evaluated the prevalence of HPV infections and the distribution of their genotypes among clinic patients and healthy women in Beijing, China.

METHODS

Cervical specimens were collected from 12,100 patients and 1176 subjects who underwent physical examinations at Dongzhimen Hospital, Beijing University of Chinese Medicine, between March 2016 and September 2020. HPV genotyping was performed using commercial kits designed to detect 15 high-risk and 2 low-risk HPV genotypes.

RESULTS

There was a higher overall prevalence of HPV among the clinic patients (21.0%) than among the healthy women (11.9%). The most common HPV genotypes among the patients were: HPV-52 (5.4%), HPV-16 (3.4%), HPV-58 (3.2%), HPV-51 (2.6%), HPV-39 (2.0%), HPV-56 (2.0%), and HPV-66 (2.0%). Among the healthy women: HPV-52 (3.0%), HPV-51 (1.8%), HPV-58 (1.6%), HPV-66 (1.5%), HPV-16 (1.2%), HPV-56 (1.2%), and HPV-18 (1.1%). Multiple HPVs were detected in 29.1% of the gynecological outpatients and in 23.6% of the women receiving physical examinations. The most common pairs of HPV types detected were HPV-52 and HPV-16 in the clinic patients, and HPV-52 and HPV-56 in the healthy women. Age-specific HPV positivity and peak prevalence were observed among the individuals in both groups for women aged less than 25 years and those between 61 and 65 years of age.

CONCLUSIONS

Our results provide current estimates of HPV prevalence and genotypes in the Beijing region. The epidemiological characteristics observed also provide a reference for the development of cervical cancer screening strategies and selection of HPV vaccine antigen targets for this region. A comparison of these HPV prevalence data with those from other regions suggests that regional vaccines may be an important direction for future research.

Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.

Factors associated with intention of human papillomavirus vaccination among Chinese college students: implications for health promotion

Human papilloma virus (HPV) is the most common reproductive tract virus. Most HPV infections occur during adolescence or young adulthood, and thus college students are one of the main target populations of HPV vaccination. However, data on knowledge of HPV and HPV vaccine as well as the intention to be vaccinated among Chinese college students were limited. The purpose of this study was to address this gap by investigating a sample of college students from four universities and analyzing the factors influencing their intention. College students (N = 343) filled in a survey comprised of demographic information, HPV and vaccine knowledge, and vaccination intention between September 2018 and January 2019. A descriptive statistical analysis was conducted to describe students' HPV-related knowledge and vaccination intention. Logistic regression analysis was used to determine the predictors of HPV vaccination intention. The participants had low levels of HPV and HPV vaccine-related knowledge, as well as modest intention to be vaccinated. Significant differences were identified in gender, years of study, and perceived susceptibility of HPV infection. Students who perceived higher risk of HPV infection (OR = 6.659, p = .001), had higher level knowledge of HPV vaccine (OR = 2.697, p < .001), in junior (OR = 0.186, p = .006) and senior year (OR = 0.276, p = .015) had greater intention to get HPV vaccinated. The findings suggest that multiple-level efforts are continuously needed to target Chinese college students to increase their HPV vaccine knowledge and vaccination awareness to reduce HPV-related disease burden among this population.

Promoting HPV vaccination on social media: interactive effects of threat, efficacy and social cues

BACKGROUND

Women are currently facing a tremendous threat of cervical cancer globally. Social media health campaigns have the potential to shape public health behaviors. This study explores the effects of cervical-cancer-related fear appeal messages with social cues on social media using the extended parallel processing model (EPPM).

METHOD

We use a 2 (threat: present vs. absent) × 2 (efficacy: present vs. absent) × 2 (social cues: high vs. low) factorial experimental design to examine the effects of fear appeal messages with social cues on behavioral intention to receive the human papillomavirus (HPV) vaccination.

RESULTS

There was a significant main effect of threat on the intention to receive HPV vaccination. Additionally, a significant three-way interactive effect among threat, efficacy, and social cues was detected.

CONCLUSION

Women exposed to threat messages had a higher intention of HPV vaccination compared to those who were exposed to non-threat messages. Furthermore, with the low number of likes, women who were exposed to messages containing both threat and efficacy tended to have the highest intention of HPV vaccination.

PRACTICE IMPLICATIONS

When conducting fear appeal campaigns on social media, the side effects of number of likes should be recognized. For vaccination promotion campaigns, the efficacy information should be more specific and audience-centered.