title: Human papillomavirus infection in women with and without cervical cancer in Tbilisi, Georgia.
abstract: BACKGROUND
  No accurate estimates of cervical cancer incidence or mortality currently exist in Georgia. Nor are there any data on the population-based prevalence of high-risk (HR) human papillomavirus (HPV) infection, which, in the absence of good-quality screening, is known to correlate with cervical cancer incidence.
  
  
  METHODS
  We obtained cervical cell specimens from 1309 women aged 18-59 years from the general population of Tbilisi, and also from 91 locally diagnosed invasive cervical cancers (ICC). DNA of 44 HPV types was tested for using a GP5+/6+-based PCR assay.
  
  
  RESULTS
  In the general population (of whom 2% reported a previous Pap smear) HPV prevalence was 13.5% (95% CI: 11.6-15.9), being highest in women aged 25-34 years (18.7%) and falling to between 8.6% and 9.5% for all age groups above 34 years. HR HPV prevalence was 8.6% overall, being 6.8% and 38.9% among women with normal and abnormal cytology, respectively. HPV45 (1.6%) was the most common type in women with normal cytology, whereas HPV16 predominated among women with cervical abnormalities (including 7 of 10 histologically confirmed cervical intraepithelial neoplasia 2/3) and among ICC (57.6%). The next most common types in ICC in Georgia were HPV45 and 18 (13.2 and 11.0%, respectively).
  
  
  CONCLUSIONS
  We report a relatively high burden of HPV infection in Tbilisi, Georgia. Improving cervical cancer prevention, through screening and/or HPV vaccination, is an important public health issue in Georgia, where 70% of ICC are theoretically preventable by HPV16/18 vaccines.
authors.affiliation: Alexandre Natishvili Institute of Morphology, 2 Chiaureli St., Tbilisi 0159, Georgia.
authors.forename: Tamar
authors.initials: T
authors.lastname: Alibegashvili
authors.forename: Gary M
authors.initials: GM
authors.lastname: Clifford
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vaccarella
authors.forename: Alexi
authors.initials: A
authors.lastname: Baidoshvili
authors.forename: Liana
authors.initials: L
authors.lastname: Gogiashvili
authors.forename: Zurab
authors.initials: Z
authors.lastname: Tsagareli
authors.forename: Ioseb
authors.initials: I
authors.lastname: Kureli
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Daniëlle A M
authors.initials: DA
authors.lastname: Heideman
authors.forename: Folkert J
authors.initials: FJ
authors.lastname: van Kemenade
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: Dimitri
authors.initials: D
authors.lastname: Kordzaia
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral