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Yang H, Xie Y, Guan R, Zhao Y, Lv W, Liu Y, Zhu F, Liu H, Guo X, Tang Z, Li H, Zhong Y, Zhang B, Yu H. Factors affecting HPV infection in U.S. and Beijing females: A modeling study. Front Public Health 2022; 10:1052210. [PMID: 36589946 PMCID: PMC9794849 DOI: 10.3389/fpubh.2022.1052210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is an important carcinogenic infection highly prevalent among many populations. However, independent influencing factors and predictive models for HPV infection in both U.S. and Beijing females are rarely confirmed. In this study, our first objective was to explore the overlapping HPV infection-related factors in U.S. and Beijing females. Secondly, we aimed to develop an R package for identifying the top-performing prediction models and build the predictive models for HPV infection using this R package. Methods This cross-sectional study used data from the 2009-2016 NHANES (a national population-based study) and the 2019 data on Beijing female union workers from various industries. Prevalence, potential influencing factors, and predictive models for HPV infection in both cohorts were explored. Results There were 2,259 (NHANES cohort, age: 20-59 years) and 1,593 (Beijing female cohort, age: 20-70 years) participants included in analyses. The HPV infection rate of U.S. NHANES and Beijing females were, respectively 45.73 and 8.22%. The number of male sex partners, marital status, and history of HPV infection were the predominant factors that influenced HPV infection in both NHANES and Beijing female cohorts. However, condom application was not an independent influencing factor for HPV infection in both cohorts. R package Modelbest was established. The nomogram developed based on Modelbest package showed better performance than the nomogram which only included significant factors in multivariate regression analysis. Conclusion Collectively, despite the widespread availability of HPV vaccines, HPV infection is still prevalent. Compared with condom promotion, avoidance of multiple sexual partners seems to be more effective for preventing HPV infection. Nomograms developed based on Modelbest can provide improved personalized risk assessment for HPV infection. Our R package Modelbest has potential to be a powerful tool for future predictive model studies.
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Affiliation(s)
- Huixia Yang
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yujin Xie
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Rui Guan
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yanlan Zhao
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weihua Lv
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ying Liu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Feng Zhu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Huijuan Liu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xinxiang Guo
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhen Tang
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Haijing Li
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yu Zhong
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,Yu Zhong
| | - Bin Zhang
- Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,Bin Zhang
| | - Hong Yu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,*Correspondence: Hong Yu
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Hampson IN. Effects of the Prophylactic HPV Vaccines on HPV Type Prevalence and Cervical Pathology. Viruses 2022; 14:v14040757. [PMID: 35458487 PMCID: PMC9029410 DOI: 10.3390/v14040757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 02/02/2023] Open
Abstract
Vaccination programs with the current prophylactic HPV vaccines started in most countries around 2008 with introduction of the bivalent Cervarix HPV16/18 vaccine, rapidly followed by Gardasil (HPV6/11/16/18) and, finally, Gardasil 9 (HPV6/11/16/18/31/33/45/52/58), from 2015. Many studies have now confirmed their ability to prevent infection with vaccine-covered HPV types, and the subsequent development of either genital warts and/or cervical neoplasia, although this is clearly more effective in younger women vaccinated prior to sexual debut. Most notably, reductions in the prevalence of vaccine-covered HPV types were also observed in unvaccinated women at the same geographical location, presumably by sexual dissemination of these changes, between vaccinated and unvaccinated women. Furthermore, there are several studies that have demonstrated vaccine-associated HPV type-replacement, where vaccine-covered, high-risk HPV types are replaced by high-risk HPV types not covered by the vaccines, and these changes were also observed in vaccinated and unvaccinated women in the same study population. In light of these observations, it is not entirely clear what effects vaccine-associated HPV type-replacement will have, particularly in older, unvaccinated women.
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Affiliation(s)
- Ian N Hampson
- Division of Cancer Sciences, University of Manchester, Oxford Rd, Manchester M13 9WL, UK
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Distribution of HPV Genotypes Differs Depending on Behavioural Factors among Young Women. Microorganisms 2021; 9:microorganisms9040750. [PMID: 33918429 PMCID: PMC8066411 DOI: 10.3390/microorganisms9040750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022] Open
Abstract
Risk factors for the different human papillomavirus (HPV) genotypes are not well understood, although the risk of cancer is known to vary among them. Our aim was to evaluate the association of diverse behavioral and reproductive factors with genotype-specific HPV prevalence among 879 unvaccinated women aged 18–75 years referred to the colposcopy clinic at Helsinki University Hospital in Finland. Cervical swabs for HPV genotyping were collected in the first visit and assessed for 34 high-risk (hr) and low-risk (lr) HPV genotypes. Participants completed a questionnaire on behavioral, reproductive, and lifestyle factors. Differences in genotype-specific HPV prevalence were analyzed overall and in age groups using binary logistic regression. Smoking was associated with higher prevalence in HPV16 compared with other hrHPV genotypes together with decreasing age, being highest among younger women <30 years old, odds ratio (OR) 3.74 (95% CI 1.42–9.88). The later the sexual debut, the more it seemed to protect from HPV16 infection. The best protection was achieved when the sexual debut took place at >20 years of age, with an OR of 0.43 (95% CI 0.23–0.83). This association was not seen with other hrHPV genotypes. Methods of contraception seemed not to have an effect on hrHPV positivity, regardless of the HPV genotype. The genotype specific hrHPV prevalence differs, depending on behavioral factors, especially among younger women referred to colposcopy.
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