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Open Access Research article

Seroprevalence of Human Papillomavirus Types 6, 11, 16 and 18 in Chinese Women

Jia Ji12, Hai-Kui Sun1, Jennifer S Smith1*, He Wang1, Mark T Esser36, Shangying Hu1, Robert G Pretorius4, Wen Chen1, Jerome L Belinson5 and You-Lin Qiao17*

Author Affiliations

1 Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan, Beijing 100021, China

2 Division of Pharmaceutics, College of Pharmacy, Ohio State University, 500 W 12th Ave, Columbus, OH, 43210, USA

3 Department of Vaccine Research, Merck Research Laboratories, Merck and Company Incorporated, 770 Sumneytown Pike, West Point, PA, 19486, USA

4 Department of Obstetrics and Gynecology, S.C.P.M.G.-Fontana, 9961 Sierra Ave, Fontana, CA, 92335, USA

5 Department of Obstetrics and Gynecology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

6 Present address: PPD Vaccines and Biologics Center of Excellence, 466 Devon Park Drive, Wayne, PA, 19087, USA

7 Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, 17 Panjiayuan, Beijing 100021, China

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BMC Infectious Diseases 2012, 12:137  doi:10.1186/1471-2334-12-137

Published: 20 June 2012



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.


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.


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).


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.

Human papillomavirus; Seroprevalence; China