Human papillomavirus genotype distribution in external acuminata condylomata: a Large French National Study (EDiTH IV).
ABSTRACT External acuminata condylomata (EAC) are among the most common sexually transmitted diseases. Although it is understood that low-risk human papillomavirus (HPV) genotypes 6 and 11 are associated with EAC, there have only been a few, small, published studies reporting the genotype-specific prevalence of HPV. The objective of our study was to assess the prevalence of HPV genotypes for a large number of cases involving both men and women and to evaluate the potential benefit of a quadrivalent (genotypes 6, 11, 16, and 18) HPV vaccine in France.
A total of 256 women and 260 men who presented with EAC to French gynecologists, dermatologists, and proctologists were prospectively recruited during the period January through April 2007. Specimens were collected with a cytobrush, and the HPV genotype was determined using the INNO-LiPA assay (Innogenetics), which detects 24 HPV genotypes.
Four hundred twenty-three beta-globin-positive samples could be analyzed. The median age of patients was 30 years (range, 18-72 years). The overall prevalence of HPV DNA in patients with EAC was 99% (33% of patients were coinfected with another pathogen). Low-risk genotypes predominated, with a prevalence of 89%. The most prevalent genotypes were 6 (69%) and 11 (16%), followed by 16 (9%), 51 (8%), 52 (7%), 66 (6%) 53 (5%), 31 (3%), and 18 (3%). The cumulative prevalence of genotypes 6 and 11 was 83%, and the cumulative prevalence of genotypes 6, 11, 16, and 18 was 88%.
This study is, to our knowledge, the first large, multicenter survey to provide solid data on HPV genotype distribution among patients with EAC. Our results provide strong evidence that, in France, the most prevalent HPV genotypes in persons with EAC are 6 and 11. Because of its 99% efficacy for the prevention of EAC and a vaccine coverage of 100%, the quadrivalent HPV vaccine could prevent 62%-87% of EAC cases in France.
Article: Human papillomavirus genotype distribution in cervical samples collected in routine clinical practice at the Nantes University Hospital, France.[show abstract] [hide abstract]
ABSTRACT: The objective was to assess the human papillomavirus (HPV) overall and type-specific prevalence in smears collected during routine clinical practice. HPV genotyping and smears were performed independently between 2000 and 2006 for routine clinical follow-up (primary screening and follow-up) in the University Hospital of Nantes, France. All women with a cytological sample collected no more than 12 months before HPV genotyping were included. PCR was performed with MY09/MY11 primers and genotyping by sequencing PCR product. Overall and genotype-specific HPV prevalence were assessed according to cytological diagnosis. A total of 1,255 women were included (mean age 37.5 years). The proportion of high-risk (HR) HPV positive samples increased according to cytological diagnosis severity from 8% in normal specimens to 21% in atypical squamous cells of undetermined significance, 49% in low-grade squamous intraepithelial lesion and 75% in high-grade squamous intraepithelial lesion (HSIL) (p < 0.001). Among 980 women with normal cytology, the overall HPV prevalence varied according to age from 44% below 20 years to about 10% above 35 years (p < 0.001). The most prevalent HPV genotype in all cytological diagnoses was HPV 16. HPV 53 appeared as the second most common genotype in normal cytological samples (10.9% of HPV positive samples) but its prevalence decreased in HSIL to less than 4%. The proportion of HR HPV positive women increased according to cytological diagnosis severity. HPV 16 appeared as the most commonly encountered genotype even when the diagnosis was normal. Its prevalence increased with diagnosis severity hereby confirming that HPV 16 is more aggressive than other genotypes.Archives of Gynecology 11/2010; 284(4):989-98. · 0.91 Impact Factor
Article: Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe: a review.[show abstract] [hide abstract]
ABSTRACT: The role of human papillomavirus (HPV) in malignant and non-malignant genital diseases in women is well known and the corresponding epidemiological burden has been widely described. However, less is known about the role of HPV in anal, penile and head and neck cancer, and the burden of malignant and non-malignant HPV-related diseases in men. The objective of this review is to estimate the epidemiological burden of HPV-related cancers and non-malignant diseases in men in Europe. The annual number of new HPV-related cancers in men in Europe was estimated using Eurostat population data and applying cancer incidence rates published by the International Agency for Research on Cancer. The number of cancer cases attributable to HPV, and specifically to HPV16/18, was calculated based on the most relevant prevalence estimates. The annual number of new cases of genital warts was calculated from the most robust European studies; and latest HPV6/11 prevalence estimates were then applied. A literature review was also performed to retrieve exhaustive data on HPV infection at all anatomical sites under study, as well as incidence and prevalence of external genital warts, recurrent respiratory papillomatosis and HPV-related cancer trends in men in Europe. A total of 72, 694 new cancer cases at HPV-related anatomical sites were estimated to occur each year in men in Europe. 17,403 of these cancer cases could be attributable to HPV, with 15,497 of them specifically attributable to HPV16/18. In addition, between 286,682 and 325,722 new cases of genital warts attributable to HPV6/11were estimated to occur annually in men in Europe. The overall estimated epidemiological burden of HPV-related cancers and non-malignant diseases is high in men in Europe. Approximately 30% of all new cancer cases attributable to HPV16/18 that occur yearly in Europe were estimated to occur in men. As in women, the vast majority of HPV-positive cancer in men is related to HPV16/18, while almost all HPV-related non-malignant diseases are due to HPV6/11. A substantial number of these malignant and non-malignant diseases may potentially be prevented by quadrivalent HPV vaccination.BMC Cancer 01/2012; 12:30. · 3.01 Impact Factor