title: Human papillomavirus genotype distribution in Madrid and correlation with cytological data.
abstract: BACKGROUND
  Cervical cancer is the second most common cancer in women worldwide. Infection with certain human papillomavirus (HPV) genotypes is the most important risk factor associated with cervical cancer. This study analysed the distribution of type-specific HPV infection among women with normal and abnormal cytology, to assess the potential benefit of prophylaxis with anti-HPV vaccines.
  
  
  METHODS
  Cervical samples of 2,461 women (median age 34 years; range 15-75) from the centre of Spain were tested for HPV DNA. These included 1,656 samples with normal cytology (NC), 336 with atypical squamous cells of undetermined significance (ASCUS), 387 low-grade squamous intraepithelial lesions (LSILs), and 82 high-grade squamous intraepithelial lesions (HSILs). HPV detection and genotyping were performed by PCR using 5'-biotinylated MY09/11 consensus primers, and reverse dot blot hybridisation.
  
  
  RESULTS
  HPV infection was detected in 1,062 women (43.2%). Out of these, 334 (31%) samples had normal cytology and 728 (69%) showed some cytological abnormality: 284 (27%) ASCUS, 365 (34%) LSILs, and 79 (8%) HSILs. The most common genotype found was HPV 16 (28%) with the following distribution: 21% in NC samples, 31% in ASCUS, 26% in LSILs, and 51% in HSILs. HPV 53 was the second most frequent (16%): 16% in NC, 16% in ASCUS, 19% in LSILs, and 5% in HSILs. The third genotype was HPV 31 (12%): 10% in NC, 11% in ASCUS, 14% in LSILs, and 11% in HSILs. Co-infections were found in 366 samples (34%). In 25%, 36%, 45% and 20% of samples with NC, ASCUS, LSIL and HSIL, respectively, more than one genotype was found.
  
  
  CONCLUSIONS
  HPV 16 was the most frequent genotype in our area, followed by HPV 53 and 31, with a low prevalence of HPV 18 even in HSILs. The frequency of genotypes 16, 52 and 58 increased significantly from ASCUS to HSILs. Although a vaccine against HPV 16 and 18 could theoretically prevent approximately 50% of HSILs, genotypes not covered by the vaccine are frequent in our population. Knowledge of the epidemiological distribution is necessary to predict the effect of vaccines on incidence of infection and evaluate cross-protection from current vaccines against infection with other types.
authors.affiliation: Molecular Pathology Laboratory, Department of Pathology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. pmartin.hpth@salud.madrid.org
authors.forename: Paloma
authors.initials: P
authors.lastname: Martín
authors.forename: Linah
authors.initials: L
authors.lastname: Kilany
authors.forename: Diego
authors.initials: D
authors.lastname: García
authors.forename: Ana M
authors.initials: AM
authors.lastname: López-García
authors.forename: Ma José
authors.initials: MJ
authors.lastname: Martín-Azaña
authors.forename: Victor
authors.initials: V
authors.lastname: Abraira
authors.forename: Carmen
authors.initials: C
authors.lastname: Bellas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology*; D015995:Prevalence; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D055815:Young Adult
references.citation: Int J Gynecol Cancer. 2008 Mar-Apr;18(2):295-9
references.pmid: 17624987
references.citation: J Med Virol. 2009 Dec;81(12):2059-65
references.pmid: 19856480
references.citation: APMIS. 2009 Feb;117(2):108-14
references.pmid: 19239432
references.citation: PLoS One. 2011 Feb 17;6(2):e14705
references.pmid: 21379574
references.citation: J Clin Pathol. 2002 Apr;55(4):244-65
references.pmid: 11919208
references.citation: Cancer Epidemiol. 2010 Apr;34(2):162-7
references.pmid: 20080070
references.citation: Arch Pathol Lab Med. 2003 Aug;127(8):930-4
references.pmid: 12873163
references.citation: J Clin Microbiol. 2002 Sep;40(9):3341-5
references.pmid: 12202576
references.citation: BMC Infect Dis. 2009 Aug 10;9:124
references.pmid: 19664248
references.citation: Sex Transm Dis. 2003 Oct;30(10):788-93
references.pmid: 14520179
references.citation: Eur J Obstet Gynecol Reprod Biol. 2010 Jul;151(1):86-90
references.pmid: 20226583
references.citation: J Natl Cancer Inst. 2005 Jan 19;97(2):147-50
references.pmid: 15657345
references.citation: Clin Exp Obstet Gynecol. 2008;35(3):175-8
references.pmid: 18754286
references.citation: Lancet. 2007 Sep 8;370(9590):890-907
references.pmid: 17826171
references.citation: Open Virol J. 2009 Sep 04;3:60-6
references.pmid: 19750125
references.citation: J Clin Microbiol. 1997 Jun;35(6):1304-10
references.pmid: 9163434
references.citation: J Infect Dis. 2005 Mar 1;191(5):731-8
references.pmid: 15688287
references.citation: Virology. 2004 Jun 20;324(1):17-27
references.pmid: 15183049
references.citation: N Engl J Med. 2003 Feb 6;348(6):518-27
references.pmid: 12571259
references.citation: APMIS. 2011 Mar;119(3):204-15
references.pmid: 21284738
references.citation: J Infect Dis. 1994 Nov;170(5):1077-85
references.pmid: 7963696
references.citation: J Clin Microbiol. 1999 Jun;37(6):1852-7
references.pmid: 10325336
references.citation: APMIS. 2009 Jan;117(1):22-7
references.pmid: 19161533
references.citation: Lancet. 2005 Sep 17-23;366(9490):991-8
references.pmid: 16168781
references.citation: Virus Res. 2008 May;133(2):195-200
references.pmid: 18282628
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Aug;17(8):2002-6
references.pmid: 18708390
references.citation: J Clin Pathol. 2004 Jan;57(1):68-72
references.pmid: 14693839
references.citation: BMC Infect Dis. 2009 Nov 30;9:191
references.pmid: 19948015
references.citation: Lancet Oncol. 2005 May;6(5):271-8
references.pmid: 15863374
references.citation: Cancer Epidemiol Biomarkers Prev. 2003 Oct;12(10):1029-37
references.pmid: 14578139
references.citation: Virus Res. 2002 Nov;89(2):229-40
references.pmid: 12445662