Human papillomavirus 16/18 seroprevalence in unvaccinated women over 30 years with normal cytology and with high grade cervical abnormalities in Australia: results from an observational study

BMC Infectious Diseases

Karen Canfell¹  Ian H Frazer⁴  Emily Banks³  Rohit Sinha⁴  Sam Egger²  Jessica Darlington-Brown¹  Dianne L O’Connell²  Freddy Sitas²  Louiza S Velentzis² 

[1] Present address: Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, NSW Sydney 2052, NSW, Australia;Cancer Research Division, Cancer Council NSW, King’s Cross 1340, NSW, Australia;National Centre for Epidemiology and Population Health, Australian National University, Canberra 0200, ACT, Australia;The University of Queensland Diamantina Institute, Brisbane 4102, QLD, Australia

关键词: Age;    High grade cervical dysplasia;    Seroprevalence;    HPV18;    HPV 16;   

Others  :  1090205
DOI  :  10.1186/s12879-014-0676-z

 received in 2014-08-07, accepted in 2014-12-01,  发布年份 2014

【 摘 要 】

Background

Australia commenced human papillomavirus (HPV) vaccination in 2007, with a two-year catch-up to the age of 26; catch-up cohorts are thus now entering their thirties. Plans for monitoring vaccine impact involve pre- and post-vaccination assessment of cervical HPV DNA in the general population and in high grade abnormalities. Although HPV serology is less sensitive than DNA genotyping, it assesses lifetime exposure and may be easier to measure in the general population. However, benchmark pre-vaccination seroprevalence of vaccine-included types in unvaccinated women with high grade abnormalities has not previously been reported.

Methods

We assessed seroprevalence for HPV16/18 from a population-based sample of 3,729 women with normal cytology and 971 women with confirmed high grade abnormalities (CIN2/3), aged 30–64 years, unvaccinated, and recruited in New South Wales in 2006–2010. We examined the variation in HPV16/18 seropositivity by age and in relation to a range of reproductive and behavioural characteristics in the subgroup of normal cytology women with no recent history of high grade cervical disease.

Results

The HPV 16, 18 and combined seroprevalence was 19%, 7% and 24% among women with normal cytology, and 39%, 13% and 44% among women with CIN2/3, respectively. For both groups, HPV16/18 seroprevalence was highest at age 30–39 years and decreased with age. In multivariable analysis for women with normal cytology, HPV16 and HPV18 seropositivity were each associated with the number of lifetime sexual partners (p-trend <0.001 and 0.052, respectively) and for HPV16 this was also associated with age (p-trend <0.001) and prior diagnosis of Chlamydia (adjusted OR 1.89, 95% CI 1.27-2.80).

Conclusions

The findings of this study inform pre-vaccination estimates of HPV seropositivity in women with normal cytology and women with high grade abnormalities. Almost a quarter of unvaccinated women aged over 30 years with normal cytology, and more than 40% of those with CIN2/3, had seroconverted to HPV 16 or 18. These findings provide a potential additional benchmark for assessing the effects of HPV vaccination.

【 授权许可】

   
2014 Velentzis et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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