title: Overall human papilloma virus and types 16/18 prevalence in women with normal cervical cytology in Serbia: is it time for human papillomavirus testing and/or vaccination?
abstract: OBJECTIVE
  Infection with high-risk human papilloma viruses (HR-HPV), especially types 16/18, is the main factor in cervical carcinogenesis. Although the incidence of cervical cancer in Serbia is among the highest ones in Europe, data about HPV infection are insufficient. The aim of this study was to investigate the presence of overall and HPV16/18 infections in women with healthy appearance and cytologically (Pap) normal cervix.
  
  
  METHODS
  The study was performed on women who participated in this cervical cancer screening pilot study. Cervical HPV infection was detected by GP5+/6+ PCR. HPV16/18 were detected by amplification of E7/E1 viral gene, respectively.
  
  
  RESULTS
  In 350 women we got the following results: cytological abnormalities (10.3%); visible cervical changes (20.3%); previous precancerous lesion (2.3%); normal Pap and speculum finding without history of precancerous lesion (67.1%). In the last group overall HPV prevalence was 41.3%, with 10.5% HPV16 and 23.7% HPV18. The rate of multiple HPV16 plus HPV18 infections was 2.6%. HR-HPV16/18 comprised 31.6% of the total HPV positive participants.
  
  
  CONCLUSIONS
  Owing to the high prevalence of overall and HPV16/18 infections in women with healthy appearance and cytologically normal cervix, we postulate that testing/ prophylaxis for these HR-HPV types could be introduced in cervical cancer screening and preventive programmes in Serbia.
authors.affiliation: Laboratory for Molecular Genetics, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
authors.forename: Emina
authors.initials: E
authors.lastname: Malisic
authors.forename: Ksenija
authors.initials: K
authors.lastname: Brotto
authors.forename: Ana
authors.initials: A
authors.lastname: Krivokuca
authors.forename: Milena
authors.initials: M
authors.lastname: Cavic
authors.forename: Radmila
authors.initials: R
authors.lastname: Jankovic
mesh_terms: D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D052161:Human papillomavirus 18; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D055771:Serbia / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014611:Vaccination; D002578:Uterine Cervical Dysplasia / Q000821:virology*