Human Papillomavirus Genotypes in High-Grade Cervical Lesions in the United States

Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention.
The Journal of Infectious Diseases (Impact Factor: 5.85). 10/2012; 206(12). DOI: 10.1093/infdis/jis627
Source: PubMed

ABSTRACT Background. Two vaccines protect against human papillomaviruses (HPV) 16 and 18 that cause 70% of cervical cancer and 50% of cervical intraepithelial neoplasia 2/3 and adenocarcinoma in situ (CIN2+). Monitoring HPV types in CIN2+ may be used to assess HPV vaccine impact.Methods. As part of a multi-site vaccine impact monitoring project (HPV-IMPACT), biopsy specimens used to diagnose CIN2+ were obtained for HPV DNA typing for women aged 18-39 years.Results. Among 4,121 CIN2+ cases reported from 2008-2009 in 18-39 year-old women 3,058 (74.2%) were tested; 96% were HPV DNA positive. HPV16 was most common (49.1%), followed by HPV31 (10.4%) and HPV52 (9.7%). HPV18 prevalence was 5.5% overall. Proportion of CIN2+ cases associated with HPV16/18 was highest (56.3%) in 25-29 year-old women. HPV16/18-associated lesions were less common in non-Hispanic blacks (41.9%) and Hispanics (46.3%) compared to non-Hispanic whites (59.1%) (p<.0001); the difference remained significant when adjusted for covariates. Compared to non-Hispanic white, HPV35 and 58 were significantly more common in non-Hispanic black (14.5% vs. 4.2%; 12.3% vs. 3.4%) and HPV45 was higher in Hispanic cases (3.7% vs. 1.5%).Conclusion. Age and racial/ethnic differences in HPV type distribution may have implications for vaccine impact, and must be considered in monitoring trends.