title: Prevalence of human papillomavirus genotypes in cytologic abnormalities from unvaccinated women living in north-western Spain.
abstract: Cervical cancer and its precursors low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) are associated with infection by human papillomavirus (HPV), in particular HPV 16 and 18. The distribution of the HPV genotype varies with the severity of cervical disease, age and the geographic location of the patients. We report the results of a population study carried out in a region of north-western (NW) Spain aimed at determining the prevalence of single and multiple infections by 35 types of HPV using low-density microarrays for 113 cases with negative for intraepithelial lesions or malignancies; 588 with atypical squamous cells of undetermined significance (ASCUS)/LSIL; 183 with HSIL; and seven cases of squamous cell carcinomas. Of the 891 patients analysed, 50.2% had single infections and 49.8% had multiple HPV infections. In women aged below 30 years, there was a predominance of multiple infections (p = 0.027). ASCUS/LSIL was associated with multiple and HSIL with single infections (p = 0.025). We observed significant increases in the percentage of infections due to a high-risk (HR) type of HPV when the severity of the cytological lesion increased (p = 0.001). No relationship was found between greater aggressiveness in the cytological diagnosis and a higher number of HPV types involved in multiple infections. The five most frequent genotypes were HPV 16 (26.3%), 53 (18.2%), 51 (17.3%), 6 (14.8%) and 66 (13.1%). The prevalence of HPV 16, 33 and 58 increased significantly from ACUS/LSIL to HSIL and the prevalence of HPV 51, 53 and 66 decreased. HPV 16 was the only genotype that showed a significant increase in prevalence when the severity of the cytological disease increased in single infections (p = 0.0001). The implementation of bivalent prophylactic vaccination could potentially lead to prevention in 32% of the population included in the study - in at least a quarter of patients with ACUS/LSIL (26.7%), and in half of HSIL (50.2%).
authors.affiliation: Department of Pathology, Hospital Universitario de Salamanca, Spain. anaotero@usal.es
authors.forename: Ana Pastora
authors.initials: AP
authors.lastname: Otero-Motta
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ordóñez
authors.forename: Rafael
authors.initials: R
authors.lastname: González-Celador
authors.forename: Belen
authors.initials: B
authors.lastname: Rivas
authors.forename: María Del Carmen García
authors.initials: Mdel C
authors.lastname: Macías
authors.forename: Agustín
authors.initials: A
authors.lastname: Bullón
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Abad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D053918:Papillomavirus Vaccines / Q000494:pharmacology; D013030:Spain / Q000453:epidemiology; D002577:Uterine Cervical Diseases / Q000453:epidemiology* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines