title: Shift in prevalence of HPV types in cervical cytology specimens in the era of HPV vaccination.
abstract: The aim of the present population-based cohort study was to analyze the association between the prevalence of 32 types of human papilloma virus (HPV) in 615 female patients with abnormal cervical cytopathology findings. In total, 32 HPV types were screened by DNA array technology. HPV infection was detected in 470 women (76.42%), 419 of whom (89.15%) were infected with ≥1 high-risk (HR)-HPV type. HPV16, which is recognized as the main HR-HPV type responsible for the development of cervical cancer, was observed in 32.98% of HPV+participants, followed by HPV42 (18.09%), HPV31 (17.66%), HPV51 (13.83%), HPV56 (10.00%), HPV53 (8.72%) and HPV66 (8.72%). The prevalence of HR-HPV types, which may be suppressed directly (in the case of HPV16 and 18), or possibly via cross-protection (in the case of HPV31) following vaccination, was considerably lower in participants ≤22 years of age (HPV16, 28.57%; HPV18, 2.04%; HPV31, 6.12%), compared with participants 23-29 years of age (HPV16, 45.71%; HPV18, 7.86%; HPV31, 22.86%), who were less likely to be vaccinated. Consequently, the present study hypothesizes that there may be a continuous shift in the prevalence of HPV types as a result of vaccination. Furthermore, the percentage of non-vaccine HR-HPV types was higher than expected, considering that eight HPV types formerly classified as 'low-risk' or 'probably high-risk' are in fact HR-HPV types. Therefore, it may be important to monitor non-vaccine HPV types in future studies, and an investigation concerning several HR-HPV types as risk factors for the development of cervical cancer is required.
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Part Shared Practice Molecular Pathology South Bavaria, D-81675 Munich, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Bettstetter
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Becher
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany; Part Shared Practice Molecular Pathology South Bavaria, D-81675 Munich, Germany.
authors.forename: Marlene
authors.initials: M
authors.lastname: Lessel
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany.
authors.forename: Cyril
authors.initials: C
authors.lastname: Bank
authors.affiliation: Institute of Pathology Rosenheim, D-83022 Rosenheim, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Krams
authors.affiliation: Institute of Pathology Rosenheim, D-83022 Rosenheim, Germany.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Becker
authors.affiliation: Institute of Pathology Erlangen, D-91054 Erlangen, Germany.
authors.forename: Arndt
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jagla
authors.affiliation: Institute of Pathology Kaufbeuren-Ravensburg, D-87600 Kaufbeuren, Germany; Part Shared Practice Molecular Pathology South Bavaria, D-81675 Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gaumann
keywords: HPV16; cervical cancer; high-risk HPV; human papilloma virus; squamous intraepithelial lesions