Prevalence of cervical infection with HPV type 16 and 18 in Vietnam: implications for vaccine campaign

BMC Cancer

Lan TH Vu²  Dieu Bui¹  Ha TT Le² 

[1] National Cancer Institute, 43- Quan Su Street –Hoan Kiem, Hanoi, Vietnam

[2] Department of Epidemiology& Biostatistics, Hanoi school of public health, 138 Giang Vo Street, Ba Dinh, Hanoi, Vietnam

关键词: HPV vaccine;    HPV 18;    HPV 16;    Vietnam;    Human papilloma virus;    Cervical cancer;   

Others  :  1079937
DOI  :  10.1186/1471-2407-13-53

 received in 2012-09-14, accepted in 2013-01-31,  发布年份 2013

【 摘 要 】

Background

The Expanded Program on Immunization currently considers offering Human Papilomavirus vaccine on a routine basis in Vietnam. However, as the current available vaccine can prevent only two types HPV 16 and 18, before implementing a large-scale vaccine campaign we need information about the prevalence of infection with only HPV 16 and 18 in Viet Nam. This study was done in 5 large cities in Vietnam to estimate the prevalence of HPV 16 and/or 18 infections and to explore the distribution of other high risk types of HPV among married women in these provinces.

Methods

The study employed a cross-sectional design with multistage sampling. The sample size included 4500 married women in two rounds (aged ranged from 18-69 years old, median age: 40 year old). Participant were randomly selected, interviewed and given gynaecological examinations. HPV infection status (by real-time PCR kit using TaqMan probe) and HPV genotyping test (by Reverse dot blot) were done for all participants.

Results

The prevalence of cervical infection with HPV type 16 and/or 18 among married women in this study ranged from 3.1% to 7.4%. Many positive HPV cases (ranged from 24.5% to 56.8%) were infected with other type of high risk HPV which can lead to cervical cancer and cannot prevented by currently available vaccines. In addition to HPV 16 and/or 18, most common types of high risk HPV were types 58, 52, 35 and 45. Awareness about HPV and HPV vaccines was still low in the study samples.

Discussion

While it is relevant to implement an HPV vaccine campaign in Viet Nam, it is important to note that one can be infected with multiple types of HPV. Vaccination does not protected against all type of high risk HPV types. Future vaccine campaigns should openly disclose this information to women receiving vaccines.

Conclusion

High prevalence of infection with HPV high risk types was observed in this study. As HPV infection has a high correlation with cervical cancer, this study emphasizes the need for both primary prevention of cervical cancer with HPV vaccines as well as secondary prevention with screening.

【 授权许可】

   
2013 Vu et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Goldstein M, et al.: Case records of the Massachusetts General Hospital. Case 10–2009. A 23-year-old woman with an abnormal Papanicolaou smear. New Engl J Med 2009, 360(13):1337-1344.
• [2]Parkin DM: Cancers attributable to infection in the UK in 2010. Br J Cancer 2011, 105(S):49-56.
• [3]Pham THA: Cancer registration in Vietnam. Asian Pac J Cancer Prev 2001, 2(IARC Suppl):85-90.
• [4]Villa L, et al.: Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol 2005, 6:271-278.
• [5]Gasparini R, et al.: Safety and tolerability of bivalent HPV vaccine: an Italian post-licensure study. Human Vaccine 2011, 7(Suppl):136-146.
• [6]Guan P, et al.: Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer 2012, 131(10):2349-2359.
• [7]Vu TH L, Bui D: Prevalence of cervical HPV infection among married women in Vietnam 2011. Asian Pac J Cancer Prev 2012, 13(1):37-40.
• [8]Pham THA, et al.: Human Papilloma Virus in Women in the South and the North of Vietnam. Int J Cancer 2002, 104(2):213-220.
• [9]Van den Brule AJC, et al.: GP5+/6+ PCR followed by reverse line blot analysis enables rapid and high-throughput identification of human papillomavirus genotypes. J Clin Microbiol 2002, 40:779-787.
• [10]National Institute of Cancer: National registry system for cervical cancer in Vietnam. report “Statistics of provincial prevalence of cervical cancer” 2007.
• [11]Kjaer S: Type specific persistence of high risk human papillomavirus (HPV) as indicator of high grade cervical squamous intraepitheliallesions in young women: population based prospective follow up study. BMJ 2002, 325:1-7.
• [12]Tatti S: Epidemiology of HPV. Colposcopy Management options 2003, 1:1-5.
• [13]Clifford G, et al.: Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer 2003, 88(1):63-73.
• [14]Wheeler C, et al.: Cross-protective efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by non-vaccine oncogenic HPV types: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncology 2012, 13(1):100-110.
• [15]Kreimer AR, et al.: Proof-of-Principle Evaluation of the Efficacy of Fewer than Three Doses of a Bivalent HPV16/18 Vaccine. J Natl Cancer Inst 2011. First published online
• [16]Le Minh H: “Screen And Treat” Model To Combat Cervical Cancer In Vietnamese Women. 2012. Available from: http://www.asianscientist.com/health-medicine/screen-and-treat-model-cervical-cancer-vietnam/ webcite
• [17]Nidhi J, et al.: Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States, National Immunization Survey—Adult 2007. Preventive Medicine 2009, 48(5):426-431.
• [18]Chung LK, et al.: Awareness of Cervical Cancer and HPV Vaccination and Its Affordability among Rural Folks in Penang Malaysia. Asian Pac J Cancer Prev 2011, 12:1429-1435.
• [19]Giuliano AR, Papenfuss M: Human Papillomavirus Infection at the United States - Mexico Border: Implications for Cervical Cancer Prevention and Control Cancer Epidemiology. Biomarkers Prev 2001, 10:1129-1136.