HPV Genotype Distribution According to Severity of Cervical Neoplasia
KD Sjoeborg, AK Lie, A Trope, CM Jonassen, C Cuschieri, A Eskild. Oestfold Hospital Trust, Fredrikstad, Norway; Akershus University Hospital, Loerenskog, Norway; Norwegian Radium Hospital, Oslo, Norway; Akershus University Hospital, Loersenskog, Norway; Royal Infirmary, Edinburgh, United Kingdom; University of Oslo, Oslo, Norway
Background: Knowledge of the HPVgenotype distribution on a population based level is important to estimate the potential effect of the HPV vaccines. The aims of our study were to investigate the HPV genotype profile and the prevalence of multiple infections according to severity of cervical neoplasia.
Design: Cross sectional study including women with CIN2+ in Health Region East Norway during 2005 and 2006 (N=643). Median age was 35 years (range, 17-76 years). Histology revealed CIN2 in 135, CIN3/ACIS in 495 and invasive carcinoma in13 women. HPV genotypes were detected by the L1 based PCR test Linear Array, which differentiates 37 HPV genotypes. Logistic regression adjusted for age was used to evaluate the role of the different HPV genotypes according to severity of lesion. Single HPV infections except HPV16, 18, 31 and 33 were used as a reference.
Results: HPV was detected in 98% of the women of whom 53 % had multiple infections. HPV16 was the most common genotype detected in 51%, followed by HPV31, 33, 52, 18, and 51. HPV16/18 were detected in 58% of whom 35% without concurrence of other high-risk genotypes. HPV16 and HPV33 as single infections were more common in CIN3+ as compared to CIN2, age adjusted odds ratio5.93 (95% CI: 2.73-12.87) and 4.57 (95% CI: 1.43-14.60) respectively. Also in combination with other genotypes, HPV16 and HPV33 were associated with CIN3+, OR 2.30 (95% CI: 1.16-4.58) and 3.37 (95% CI: 1.10-10.34) respectively. Multiple HPV infections, not including HPV16 or HPV33, did not seem to be associated with severity of lesion, OR 1.37 (95% CI 0.72-2.59).
Conclusions: HPV16 and HPV33 as single or multiple infections were associated with CIN3+. Multiple infections with other genotypes were not associated with severity of the lesion. Based on our analyses, prophylactic vaccines against HPV16/18 seem to have the potential to prevent at least 35% of high-grade preinvasive lesions. If HPV16/18 is the causal agent even in the presence of other high-risk genotypes, the preventive potential could be 58%.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 174, Tuesday Morning