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Open Access Highly Accessed Research article

Prevalence of high-risk HPV types and associated genital diseases in women born in 1988/89 or 1983/84 – results of WOLVES, a population-based epidemiological study in Wolfsburg, Germany

Karl Ulrich Petry1*, Alexander Luyten1, Annika Justus2, Angelika Iftner3, Sarah Strehlke1, Axel Reinecke-Lüthge4, Elisabeth Grunwald5, Renate Schulze-Rath6 and Thomas Iftner3

Author Affiliations

1 Klinikum Wolfsburg, Frauenklinik, Schwerpunkt gynäkologische Onkologie, Sauerbruchstr.7, Wolfsburg, 38440, Germany

2 Conreso GmbH, Klinische Forschung, Neuhauser Straße 47, Munich, 80331, Germany

3 Universitätsklinikum Tübingen, Institut für Virologie, Sektion Experimentelle Virologie, Elfriede Aulhorn Str. 6, Tübingen, 72076, Germany

4 Klinikum Wolfsburg, Institut für Pathologie, Sauerbruchstr. 7, Wolfsburg, 38440, Germany

5 Praxis für Frauenheilkunde, Kaufhofpassage 5-7, Wolfsburg, 38440, Germany

6 Sanofi Pasteur MSD GmbH, Paul Ehrlich Strasse, Leimen, 69181, Germany

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BMC Infectious Diseases 2013, 13:135  doi:10.1186/1471-2334-13-135

Published: 13 March 2013

Abstract

Background

High-risk human papilloma virus (HR-HPV) infection is associated with the development of cervical cancer. HPV vaccination reduces the risk of developing malignant lesions and is expected to change the dynamics of HPV transmission. Data from non-vaccinated women may provide an important benchmark to allow the impact of HPV vaccination programs to be assessed.

This study was designed to prospectively determine the changing dynamics of HR-HPV infection and associated genital diseases in young women, most of whom were non-vaccinated.

Methods

Data from a population-based cohort study, comprising women of two predefined birth cohorts (women born in 1983/84 or 1988/89), were analyzed between 19 October 2009 and 31 December 2010 to determine risk factors for high-risk HPV infection and the association between specific HR-HPV types and atypical Pap smear test results. HPV status was determined by Hybrid Capture 2 (HC2) assay and genotyping.

Results

The prevalence of HR-HPV was 22.8% in the 1983/84 cohort (150/659) and 23.7% in the 1988/99 cohort (142/599). Only the number of sexual partners was a significant risk factor for HPV infection (odds ratios 22.687 and 6.124 for more than five versus one partner 84 cohort,/84 and 1988/89 cohorts, respectively) in multivariate analysis. HPV16 positive-women were significantly more likely to have abnormal Pap smears of any degree than HPV16-negative women (22.0% versus 3.61%, p < 0.0001 for the 1983/84 cohort and 9.09% versus 2.52%, p = 0.0482 for the 1988/89 cohort). CIN3 was diagnosed in six women 84 cohort,/84 cohort and two in the 1988/89 cohort. All women with CIN3 tested positive for HC2-HR and all six CIN3 cases 84 cohort,/84 cohort tested positive for HPV16. In the 1988/89 cohort, the rate of HPV16 infection was significantly lower in vaccinated than non-vaccinated women (1.59% versus 8.88%; p = 0.003).

Conclusions

HR-HPV infection was highly prevalent in both cohorts and associated with an increased risk of abnormal Pap smears and biopsy proven CIN2+. HPV16 infection was associated with a high risk of clinically relevant lesions. HPV vaccination significantly decreased the risk of HPV16 infection.

Keywords:
High-risk HPV; HPV16; CIN; HPV vaccination