title: Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China.
abstract: BACKGROUND
  Type-specific high-risk HPV (hrHPV) infection is related to cervical carcinogenesis. The prevalence of hrHPV infection varies geographically, which might reflect the epidemiological characteristics of cervical cancer among different populations. To establish a foundation for HPV-based screening and vaccination programs in China, we investigated the most recent HPV prevalence and genotypic distributions in different female age groups and geographical regions in China.
  
  
  METHODS
  In 2012, a total of 120,772 liquid-based cytological samples from women enrolled for population- or employee-based cervical screening in 37 Chinese cities were obtained by the Laboratory of Molecular Infectious Diseases of Guangzhou KingMed. A total of 111,131 samples were tested by Hybrid Capture II and the other 9,641 were genotyped using the Tellgenplex™ HPV DNA Assay.
  
  
  RESULTS
  The total positive rate for hrHPV was 21.07 %, which ranged from 18.42 % (Nanchang) to 31.94 % (Haikou) and varied by region. The regions of Nanchang, Changsha, Hangzhou, Chengdu, Fuzhou, Guangdong, and Guiyang could be considered the low prevalence regions. Age-specific prevalence showed a "two-peak" pattern, with the youngest age group (15-19 years) presenting the highest hrHPV infection rate (30.55 %), followed by a second peak for the 50-60-year-old group. Overall, the most prevalent genotypes were HPV16 (4.82 %) and HPV52 (4.52 %), followed by HPV58 (2.74 %). Two genotypes HPV6 (4.01 %) and HPV11 (2.29 %) were predominant in the low-risk HPV (lrHPV) type, while the mixed genotypes HPV16 + 52 and HPV52 + 58 were most common in women with multiple infections.
  
  
  CONCLUSIONS
  This study shows that HPV infection in China has increased to the level of an "HPV-heavy-burden" zone in certain regions, with prevalence varying significantly among different ages and regions. Data from this study represent the most current survey of the nationwide prevalence of HPV infection in China, and can serve as valuable reference to guide nationwide cervical cancer screening and HPV vaccination programs.
authors.affiliation: Division of Clinical Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin, China. wangrong825@126.com.|Department of Gynecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. wangrong825@126.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Microbiology, Kingmed Diagnostics, Guangzhou, China. labguoxiaolei@kingmed.com.cn.
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Guo
authors.affiliation: Department of Gynecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. g.b.a.wisman@umcg.nl.
authors.forename: G Bea A
authors.initials: GB
authors.lastname: Wisman
authors.affiliation: Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. e.schuuring@umcg.nl.
authors.forename: Ed
authors.initials: E
authors.lastname: Schuuring
authors.affiliation: Department of Microbiology, Kingmed Diagnostics, Guangzhou, China. wangwenfeng840825@163.com.
authors.forename: Wen-Feng
authors.initials: WF
authors.lastname: Wang
authors.affiliation: Department of Microbiology, Kingmed Diagnostics, Guangzhou, China. labzzy@kingmed.com.cn.
authors.forename: Zheng-Yu
authors.initials: ZY
authors.lastname: Zeng
authors.affiliation: Department of Epidemiology & Biostatistics, Tianjin Medical University, Tianjin, China. zhuhongepi@126.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Division of Clinical Microbiology, School of Laboratory Medicine, Tianjin Medical University, Tianjin, China. lab-wushangwei@kingmed.com.cn.|Department of Microbiology, Kingmed Diagnostics, Guangzhou, China. lab-wushangwei@kingmed.com.cn.
authors.forename: Shang-Wei
authors.initials: SW
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D004279:DNA, Viral / Q000235:genetics*; D055088:Early Detection of Cancer; D005260:Female; D005838:Genotype; D052140:Human papillomavirus 11 / Q000235:genetics; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D015995:Prevalence; D012306:Risk; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control / Q000821:virology
chemical_list: D004279:DNA, Viral; D053918:Papillomavirus Vaccines