title: Human papillomavirus infection in women with and without cervical cancer in Karachi, Pakistan.
abstract: BACKGROUND
  No data exist on the population prevalence of, or risk factors for, human papillomavirus (HPV) infection in predominantly Muslim countries in Asia.
  
  
  METHODS
  Cervical specimens were obtained from 899 married women aged 15-59 years from the general population of Karachi, Pakistan and from 91 locally diagnosed invasive cervical cancers (ICCs). HPV was detected using a GP5+/6+ PCR-based assay.
  
  
  RESULTS
  The prevalence of HPV in the general population was 2.8%, with no evidence of higher HPV prevalence in young women. The positivity of HPV was associated with women's lifetime number of sexual partners, but particularly with the age difference between spouses and other husbands' characteristics, such as extramarital sexual relationships and regular absence from home. The HPV16/18 accounted for 24 and 88% of HPV-positive women in the general population and ICC, respectively.
  
  
  CONCLUSIONS
  Cervical cancer prevention policies should take into account the low HPV prevalence and low acceptability of gynaecological examination in this population.
authors.affiliation: Department of Surgery, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
authors.forename: S A
authors.initials: SA
authors.lastname: Raza
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
authors.forename: S
authors.initials: S
authors.lastname: Pallardy
authors.forename: F R
authors.initials: FR
authors.lastname: Malik
authors.forename: B I
authors.initials: BI
authors.lastname: Avan
authors.forename: A
authors.initials: A
authors.lastname: Zafar
authors.forename: S H
authors.initials: SH
authors.lastname: Ali
authors.forename: S
authors.initials: S
authors.lastname: Pervez
authors.forename: S
authors.initials: S
authors.lastname: Serajuddaula
authors.forename: P J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: F J
authors.initials: FJ
authors.lastname: van Kemenade
authors.forename: C J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: S
authors.initials: S
authors.lastname: Shershah
authors.forename: G M
authors.initials: GM
authors.lastname: Clifford
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology
chemical_list: D004279:DNA, Viral
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