Prevalence of human papillomavirus in young Italian women with normal cytology: how should we adapt the national vaccination policy?

BMC Infectious Diseases

Roberto Gasparini⁵  Stefania Rossi¹  Angela Bechini²  Piero Luigi Lai⁵  Carla Maria Zotti³  Elena Rosanna Frati⁴  Silvia Bianchi⁴  Elisabetta Tanzi⁴  Daniela Amicizia⁵  Donatella Panatto⁵ 

[1] Department of Molecular and Developmental Medicine, Siena University, Siena, Italy;Department of Health Sciences, Florence University, Florence, Italy;Department of Public Health and Paediatrics Sciences, Turin University, Turin, Italy;Department of Biomedical Sciences for Health, Milan University, Milan, Italy;Department of Health Sciences, Genoa University, Via Pastore, 1, Genoa 16132, Italy

关键词: Young women;    HPV epidemiology;    Vaccination;    Cervical cancer prevention;    HPV;    Papillomavirus;   

Others  :  1145340
DOI  :  10.1186/1471-2334-13-575

 received in 2013-03-08, accepted in 2013-12-02,  发布年份 2013

【 摘 要 】

Background

Human Papillomavirus (HPV) is the most common sexually transmitted infection. In Italy, HPV vaccination is now offered free of charge to 12-year-old females. However, some regional health authorities have extended free vaccination to other age-groups, especially to girls under 18 years of age. We conducted a multicentre epidemiological study to ascertain the prevalence of different genotypes of HPV in young Italian women with normal cytology, with the aim of evaluating the possibility of extending vaccination to older females.

Methods

The study was performed in 2010. Women aged 16–26 years with normal cytology were studied. Cervical samples were analyzed to identify the presence of HPV by PCR amplification of a segment of ORF L1 (450 bp). All positive HPV-DNA samples underwent viral genotype analysis by means of a restriction fragment length polymorphism assay.

Results

Positivity for at least one HPV genotype was found in 18.2% of the 566 women recruited: 48.1% in the 16–17 age-class, 15.4 in the 18–20 age-class, 21.9% in the 21–23 age-class, and 15.5% in the 24–26 age-class; 10.1% of women were infected by at least one high-risk HPV genotype. HPV-16 was the most prevalent genotype. Only 4 (0.7%), 4 (0.7%) and 3 (0.5%) women were infected by HPV-18, HPV-6 and HPV-11, respectively. Of the HPV-DNA-positive women, 64.1% presented only one viral genotype, while 24.3% had multiple infections. The HPV genotypes most often involved in multiple infections were high-risk. A high prevalence was noted in the first years of sexual activity (48.1% of HPV-DNA-positive women aged 16–17 years); HPV prevalence subsequently declined and stabilized.

The estimate of cumulative proportions of young women free from any HPV infection at each age was evaluated; 93.3% and 97.1% of 26 year-old women proved free from HPV-16 and/or HPV-18 and from HPV-6 and/or HPV-11, respectively.

Conclusions

Our findings confirm the crucial importance of conducting studies on women without cytological damage, in order to optimise and up-date preventive interventions against HPV infection, and suggest that vaccinating 26-year-old females at the time of their first pap-test is to be recommend, though this issue should be further explored.

【 授权许可】

   
2013 Panatto et al.; licensee BioMed Central Ltd.

【 图 表 】

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