Seroprevalence of human papillomavirus types 6, 11, 16 and 18 in Chinese women.
BACKGROUND
Human papillomavirus (HPV) seroprevalence data have not previously been reported for different geographical regions of China. This study investigated the cross-sectional seroprevalence of antibodies to HPV 6, 11, 16, and 18 virus-like particles in Chinese women.


METHODS
Population-based samples of women were enrolled from 2006 to 2007 in 3 rural and 2 urban areas of China. Each consenting woman completed a questionnaire and provided a blood sample. Serum antibodies were detected using a competitive Luminex immunoassay that measures antibodies to type-specific, neutralizing epitopes on the virus-like particles.


RESULTS
A total of 4,731 women (median age 35, age range 14-54) were included, of which 4,211 were sexually active women (median age 37) and 520 virgins (median age 18). Low risk HPV 6 was the most common serotype detected (7.3%), followed by HPV 16 (5.6%), HPV 11 (2.9%), and HPV 18 (1.9%). Overall HPV seroprevalence to any type was significantly higher among sexually active women (15.8%) than virgins (2.5%) (P = 0.005). Overall seroprevalence among sexually active women gradually increased with age. Women from rural regions had significantly lower overall seroprevalence (Odds Ratio (OR) = 0.7; 95% CI: 0.6-0.9, versus metropolitan regions, P < 0.001). With increasing number of sexual partners, women were at higher risk of seropositivity of any type (OR = 2.6; 95% CI: 1.7-3.9 for > = 4 partners versus 1 partner, P < 0.001). Wives were at higher risk of seropositivity for HPV 16/18/6/11 when reporting having a husband who had an extramarital sexual relationship (OR = 2.0; 95% CI: 1.6-2.5, versus those whose husbands having no such relationship, P < 0.001). There was a strong association between HPV 16 seropositivity and presence of high-grade cervical lesions (OR = 6.5; 95% CI: 3.7-11.4, versus normal cervix, P < 0.001).


CONCLUSIONS
HPV seroprevalence differed significantly by age, geography, and sexual behavior within China, which all should be considered when implementing an optimal prophylactic HPV vaccination program in China.
Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan, Beijing 100021, China.
Jia
J
Ji
Hai-Kui
HK
Sun
Jennifer S
JS
Smith
He
H
Wang
Mark T
MT
Esser
Shangying
S
Hu
Robert G
RG
Pretorius
Wen
W
Chen
Jerome L
JL
Belinson
You-Lin
YL
Qiao
D000293:Adolescent; D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D052140:Human papillomavirus 11 / Q000276:immunology / Q000302:isolation & purification*; D052162:Human papillomavirus 16 / Q000276:immunology / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000276:immunology / Q000302:isolation & purification*; D052163:Human papillomavirus 6 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D012424:Rural Population; D016036:Seroepidemiologic Studies; D044967:Serum / Q000276:immunology; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral