Identification of vaccine human papillomavirus genotypes in squamous intraepithelial lesions (CIN2-3).
OBJECTIVE
To identify the prevalence of human papillomavirus vaccine genotypes and non-vaccine genotypes implicated in the appearance of cervical intraepithelial neoplasia (CIN2-3).


METHODS
Prospective study of 519 women with abnormal cytology. All the women underwent a second Papanicolaou test, cervicovaginal sampling for type-specific HPV detection and colposcopy, and women with abnormal colposcopy results were referred to biopsy. Pearson's chi-square test was used for statistical analysis.


RESULTS
HPV was detected in 340 patients (65.5%), and in 125 (24%) more than one HPV genotype was present. We selected 206 patients with CIN2 or CIN3 confirmed by biopsy. In 88 (42.7%) of these patients, HPV types 16 and 18 were detected, but only 58 (28.2%) without co-infection by other high-risk or probable high-risk HPV types. In 115 (55.8%) women diagnosed with CIN2 or CIN3 high-risk or probable high-risk HPV types other than 16 or 18 were found. High-risk and/or probable high-risk HPV genotypes not included in the vaccine were isolated in this study more frequently than 16 or 18, and this difference was statistically significant (p=0.047). Of the 206 women diagnosed with CIN2 or CIN3, 19 tested negative for HPV and 14 tested positive for low-risk HPV types.


CONCLUSIONS
Only 28.2% of women with CIN2 or CIN3 confirmed by biopsy were infected exclusively by HPV type 16 or 18, a finding that places in doubt the degree of protection afforded by HPV vaccination.
González-Bosquet
Eduardo
E
Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain. edugonzalez@hsjdbcn.org
Esteva
Cristina
C
Muñoz-Almagro
Carmen
C
Ferrer
Patricia
P
Pérez
Miriam
M
Lailla
Jose M
JM
D000328:Adult; D019092:Conization; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics / Q000276:immunology; D052161:Human papillomavirus 18 / Q000235:genetics / Q000276:immunology; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000276:immunology; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology*; D053918:Papillomavirus Vaccines / Q000235:genetics* / Q000276:immunology; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*
D053918:Papillomavirus Vaccines