title: Human papillomavirus prevalence and type-distribution among women in Zhejiang Province, Southeast China: a cross-sectional study.
abstract: BACKGROUND
  Human papillomavirus (HPV) infection is the main etiological factor for cervical cancer and premalignant lesions of the cervix. The purposes of the present study were to determine the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Zhejiang province, Southeast China.
  
  
  METHODS
  A total of 15,267 women presenting to a gynaecological outpatient clinic were enrolled in this study. Women were screened for HPV in addition to routine cervical cytology testing. Microarray hybridization and liquid-based cytology tests were used to detect HPV genotypes and cervical cytology, respectively.
  
  
  RESULTS
  Based on the population attending a gynaecological outpatient clinic, overall prevalence of any 23 HPV type was 22.8% and multiple HPV infection was found in 4.0% of all the outpatients. HPV prevalence showed bimodal age distribution, with a peak (55.7%) at the ≤20 age group and a second one (35.5%) at >60 age group. In total samples, the five most frequent types were HPV 16 (4.4%), 58 (2.9%), 52 (2.7%), 33 (2.2%) and 11 (1.9%). Overall HPV prevalence increased with the severity of the cytologic result. Analysis through crude odds ratios (ORs) revealed that the cervical lesion risk of HPV-infected women increased to about 26-fold of uninfected women (OR 26.1, 95% CI 22.4 to 30.3). The five most risky HPV types associated with abnormal cytology were HPV 73, 16, 82, 45 and 51.
  
  
  CONCLUSIONS
  This study provided baseline data on HPV prevalence in women attending a gynecological outpatient clinic in Zhejiang province. Our data will supply guidance for the primary screening and vaccination program for cervical cancer in this area.
authors.affiliation: Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China. liuxiaoxiang413@126.com.
authors.forename: Xiao-Xiang
authors.initials: XX
authors.lastname: Liu
authors.affiliation: Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China. enterjoyfan@hotmail.com.
authors.forename: Xing-Li
authors.initials: XL
authors.lastname: Fan
authors.affiliation: Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China. yueping8@gmail.com.
authors.forename: Yue-Ping
authors.initials: YP
authors.lastname: Yu
authors.affiliation: Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China. jilei0403@gmail.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Ji
authors.affiliation: Division of Basic Medical Microbiology, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, 310003, P. R. China. Med_bp@zju.edu.cn.|Department of Medical Microbiology and Parasitology, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, P. R. China. Med_bp@zju.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Yan
authors.affiliation: Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China. sunah123@126.com.
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000554:Ambulatory Care Facilities; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D017720:Molecular Epidemiology; D010045:Outpatients; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D015995:Prevalence; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral