AUTHOR=Wong Eliza Lai-Yi , Cheung Annie Wai-Ling , Chen Zigui , Wong Amy Yuen-Kwan , Yeung Apple Chung-Man , Yau Peter Sen-Yung , Chan Paul Kay-Sheung 

TITLE=Molecular Epidemiology of Human Papillomavirus Infection Among Chinese Women With Cervical Cytological Abnormalities

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.820517

DOI=10.3389/fpubh.2022.820517

ISSN=2296-2565

ABSTRACT=Background: Virtually all invasive cervical cancers are caused by persistent genital Human Papillomavirus (HPV) infection.  Therefore, HPV-based screening becomes an essential tool as one of the cervical prevention strategies to reduce the disease burden.  Population-specific epidemiologic information on HPV infection among women with cytological abnormalities is essential to inform the strategy of HPV-based screening programme.  The study also explored the presence of cutaneous HPV types (Beta-β and Gamma-γ) in cervical infections.

Method: A cross-sectional study on Chinese women aged ≥25 years who were referred to public specialist out-patient clinics for colposcopy or further management of cervical cytological abnormalities, were recruited between 2015 and 2016 in Hong Kong.  HPV was detected and typified by the novel PCR-based Next-Generation Sequencing (NGS) strategies.

Results: The overall HPV infection rate was 74% and detected in 222 of the 300 respondents, with the prevalence of cutaneous HPV infection being 2.3%.  The overall prevalence of HPV infection among women with current cytological abnormalities was 79.1% (197/249).  The age-specific prevalence of HPV (any-type HPV infection) among women with cytological abnormalities reached the first peak with 87.9% at the age group of 35-39 years and gradually declined to 56.0% at 55-59 years.  While a second peak occurred at 65 years or above (92.9%).  HPV58 (13.7%), HPV52 (11.7%), HPV53 (11.2%), HPV16 (10.0%), HPV18 (5.2%) and HPV51 (5.2%) were the top five high-risk HPV genotypes among women with cytological abnormalities.  Any-HPV type infection was significantly associated with an abnormal cervical smear (OR = 3.7; 95% CI 2.0-7.1), and high-risk HPV infection was also significantly associated with an abnormal cervical smear (OR = 6.3; 95% CI 3.0-13.5).

Conclusion: New evidence on the second peak of HPV infection at ≥65 years old suggests the necessity to review the current guideline for the cervical screening program extending to age 65 and above. Moreover, high prevalence of two HPV genotypes – high-risk HPV51 and potential high-risk HPV53, among women with cytological abnormalities – suggest further research work is needed to confirm the contributory role of HPV51 and HPV53 in cervical cancer and the needs of inclusion in the next generation of HPV vaccine.