1
|
Wang S, Ma QY, Du J, Wei TT, Zhang WX, Wang P, Zhou Y, Wei M, Gu L, Cui F, Lu QB. Detecting and genotyping high-risk human papillomavirus among male patients during 2015-2023 in Beijing, China. Emerg Microbes Infect 2024; 13:2313848. [PMID: 38318858 PMCID: PMC10866056 DOI: 10.1080/22221751.2024.2313848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Abstract
Few studies focused on human papillomavirus (HPV) in male patients. This study aimed to explore the detection rate and genotyping of HPV among male patients in Beijing to provide a reference for formulating prevention strategies for HPV infection. The cross-sectional study was conducted in Beijing Chaoyang Hospital from November 2015 to March 2023. It covered male patients from the urology and dermatology departments. Fifteen high-risk HPV genotypes were detected by the multiplex real-time polymerase chain reaction method. The overall detection rate of HPV was 25.19% (1288/5114, 95% confidence interval [CI] 24.00%-26.38%), of which the single infection rate was 16.99% (869/5114, 95% CI 15.97%-18.05%) and the co-infection rate was 8.19% (419/5114, 95% CI 7.46%-8.98%). The detection rate of HPV was 40.77% (521/1278), 35.58% (58/163), 32.69% (101/309), 31.91% (60/188), 12.63% (299/2367), and 32.35% (131/405) among male patients with balanitis, warts, rash, urethritis, prostatitis, and other urinary inflammation, respectively (P < 0.001). The top five HPV genotypes were HPV-52, HPV-58, HPV-16, HPV-51, and HPV-66. After the first positive HPV test, the proportion of male patients who turned negative was 22.47% within 3 months, 26.40% within 3-6 months, 24.72% within 6-12 months, 17.98% within 12-24 months, and 8.43% more than 24 months. The detection rate of HPV was high among male patients from the urology and dermatology departments in Beijing, which should be considered to develop HPV vaccines with better prevention effects.
Collapse
Affiliation(s)
- Shuai Wang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Qin-Yi Ma
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
| | - Juan Du
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Ting-Ting Wei
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Wan-Xue Zhang
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
| | - Peng Wang
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yiguo Zhou
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
| | - Ming Wei
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Li Gu
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Fuqiang Cui
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People’s Republic of China
- Ministry of Education, Key Laboratory of Epidemiology of Major Diseases (Peking University), Beijing, People’s Republic of China
| | - Qing-Bin Lu
- Department of Laboratorial of Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, People’s Republic of China
- Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing, People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People’s Republic of China
- Ministry of Education, Key Laboratory of Epidemiology of Major Diseases (Peking University), Beijing, People’s Republic of China
| |
Collapse
|
2
|
Wang T, Li W, Cai M, Ji S, Wang Y, Huang N, Jiang Y, Zhang Z. Human papillomavirus molecular prevalence in south China and the impact on vaginal microbiome of unvaccinated women. mSystems 2024; 9:e0073824. [PMID: 39120153 PMCID: PMC11407003 DOI: 10.1128/msystems.00738-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 08/10/2024] Open
Abstract
The vaginal microbiome (VM) is associated with human papillomavirus (HPV) infection and progression, but a thorough understanding of the relation between HPV infection, and VM needs to be elucidated. From August to December 2022, women who underwent routine gynecological examinations were screened for HPV infection. The distribution of HPV variants and clinical characteristics were collected. Then, a total of 185 participants were enrolled and divided into HPV-negative (HC), high-risk HPV (H), low-risk HPV (L), multiple high-risk HPV (HH), and mixed high-low risk HPV (HL) groups. Samples were collected from the mid-vagina of these 185 participants and sent for 16S rDNA sequencing (V3-V4 region). Among 712 HPV-positive women, the top 3 most frequently detected genotypes were HPV52, HPV58, and HPV16. Among 185 participants in the microbiology study, the β diversity of the HC group was significantly different from HPV-positive groups (P < 0.001). LEfSe analysis showed that Lactobacillus iners was a potential biomarker for H group, while Lactobacillus crispatus was for L group. Regarding HPV-positive patients, the α diversity of cervical lesion patients was remarkably lower than those with normal cervix (P < 0.05). Differential abundance analysis showed that Lactobacillus jensenii significantly reduced in cervical lesion patients (P < 0.001). Further community state type (CST) clustering displayed that CST IV was more common than other types in HC group (P < 0.05), while CST I was higher than CST IV in H group (P < 0.05). Different HPV infections had distinct vaginal microbiome features. HPV infection might lead to the imbalance of Lactobacillus spp. and cause cervical lesions. IMPORTANCE In this study, we first investigated the prevalence of different HPV genotypes in south China, which could provide more information for HPV vaccinations. Then, a total of 185 subjects were selected from HPV-negative, high-risk, low-risk, multiple hr-hr HPV infection, and mixed hr-lr HPV infection populations to explore the vaginal microbiome changes. This study displayed that HPV52, HPV58, and HPV16 were the most prevalent high-risk variants in south China. In addition, high-risk HPV infection was featured by Lactobacillus iners, while low-risk HPV infection was by Lactobacillus crispatus. Further sub-group analysis showed that Lactobacillus jensenii was significantly reduced in patients with cervical lesions. Finally, CST clustering showed that CST IV was the most common type in HC group, while CST I accounted the most in H group. In a word, this study for the first time systemically profiled vaginal microbiome of different HPV infections, which may add bricks to current knowledge on HPV infection and lay the foundation for novel treatment/prevention development.
Collapse
Affiliation(s)
- Tingting Wang
- School of Health, Quanzhou Medical College, Quanzhou, China
| | - Weili Li
- Zhangjiang Center for Translational Medicine, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Mingya Cai
- Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
- Department of Clinical Laboratory, Jinjiang Hospital, Jinjiang, China
| | - Shushen Ji
- Zhangjiang Center for Translational Medicine, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yufang Wang
- School of Health, Quanzhou Medical College, Quanzhou, China
| | - Nan Huang
- School of Health, Quanzhou Medical College, Quanzhou, China
| | - Yancheng Jiang
- Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Zhishan Zhang
- Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| |
Collapse
|
3
|
Shah PT, Wu Z, Ma R, Wu C. Genetic diversity, variation and recombination among the human papillomaviruses (HPVs) genomes isolated in China: a comparative genomic and phylogenetic analysis. Pathog Glob Health 2024:1-14. [PMID: 39263878 DOI: 10.1080/20477724.2024.2401273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024] Open
Abstract
Human papillomaviruses (HPVs) are widespread, sexually transmitted group of viruses that infect most individuals at some stage, causing genital warts and cancers. They are members of the Papillomaviridae family, which contains about 400 HPV types. China is among the high HPV burden countries with reported infections of multiple HPV types, accounting for 17.3% of global deaths and 18.2% of global new cases. Thus, understanding the genetic variation and geographic diversity characteristics of HPVs isolated in China is critical for global HPV prevention strategies. Thus, we analyzed the available HPV genome sequences isolated in China that grouped into two categories (alpha- and gamma-papillomaviruses) based on full-length genomes. The most common were HPV-16, -6, -58, and -52 respectively. In addition, four of the novel strains isolated in China, e.g. TG550, JDFY01, CH2, and L55 clustered with the HPV-mSK 159, 244, 201, and 200 respectively. Our phylogeographic network analysis indicated that the L55, TG550, and CH2 are genetically identical to the mSK 200, 046, and 201 respectively, while JDFY01 appeared separately, connected to the mSK-040 following five mutational steps. Also, we found ten recombination events among HPV-6/11 types within their E1, E2, E7, L1/L2 proteins, and Long Control Region ORFs. We achieved the consensus amino acid sequences of HPV proteins and found a conserved stretch of amino acids within E5A of all HPVs circulating in China. These findings offer valued insights into the genetic relationships, distribution, and evolution of the HPVs in China that may assist in adapting effective HPV preventive measures.
Collapse
Affiliation(s)
- Pir Tariq Shah
- Faculty of Medicine, School of Basic Medical Sciences, Dalian University of Technology, Dalian, China
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai, China
| | - Zhenyong Wu
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai, China
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Ruilan Ma
- Radiotherapy Oncology Department, The Second Affiliated Hospital of the Dalian Medical University, Dalian, China
| | - Chengjun Wu
- Faculty of Medicine, School of Basic Medical Sciences, Dalian University of Technology, Dalian, China
| |
Collapse
|
4
|
Lin K, Hong Q, Fu Y, Tu H, Lin H, Huang J, Hu Y, Huang M, Chen M. Cervical HPV infection and related diseases among 149,559 women in Fujian: an epidemiological study from 2018 to 2023. Front Microbiol 2024; 15:1418218. [PMID: 38962121 PMCID: PMC11220154 DOI: 10.3389/fmicb.2024.1418218] [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: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 07/05/2024] Open
Abstract
Objectives To comprehensively analyze the epidemiological features of human papillomavirus (HPV) and HPV-related cervical diseases in females aged 35-64 years. Methods A total of 149,559 samples of exfoliated cervical cells screened for HPV and related cervical lesions from January 2018 to December 2023 were enrolled. The prevalence of 15 high-risk and 6 low-risk HPV genotypes were detected, and the cervical cytology were analyzed. The impact of single and multiple HPV infections was characterized, and the effect of age was studied. Results The cervix cytology was normal in 86.60% of the females, while 7.13% of the females were diagnosed with cervix inflammation, 0.60% with ASC-US, 0.22% with ASC-H, 0.72% with LSIL, 0.49% with HSIL, 0.03% with ICC. The highest median age was observed in ASC-H group with 54 years old. Females with primary school education or lower have the highest positive rates. The overall HPV prevalence was 8.60%. The relatively prevalent HPV types were HPV52, 58, 16, 39, 51. HPV16, HPV18, HPV58, HPV33 and HPV52 were the top5 predominant types in ICC patients. 17.41% females suffered from multiple HPV infection with the most frequently co-infection subtypes being HPV52, HPV58 and HPV16. The prevalence of all HPV subtypes increased with age. Multiple HPV infections accounted for a larger proportion in those aged above 55 years. The peak HPV16 prevalence was observed in ICC group in cases aged 45-49 and 55-59. The peak HPV33 prevalence was observed in younger individuals aged 40-44 who developed ICC. Conclusion More action should be taken against HPV33 infection.
Collapse
Affiliation(s)
- Kun Lin
- Prenatal Diagnosis Center, The Affiliated Hospital of Putian University, Putian University, Putian, China
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Qiyang Hong
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya Fu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Haijian Tu
- Department of Laboratory Medicine, The Affiliated Hospital of Putian University, Putian University, Putian, China
| | - Hua Lin
- Department of Laboratory Medicine, The Affiliated Hospital of Putian University, Putian University, Putian, China
| | - Jiexiang Huang
- Prenatal Diagnosis Center, The Affiliated Hospital of Putian University, Putian University, Putian, China
| | - Yajing Hu
- Department of Women Health Care, Putian Maternity and Child Health Care Hospital, Putian, China
| | - Minjun Huang
- Prenatal Diagnosis Center, The Affiliated Hospital of Putian University, Putian University, Putian, China
| | - Mingqiao Chen
- Prenatal Diagnosis Center, The Affiliated Hospital of Putian University, Putian University, Putian, China
- Department of Laboratory Medicine, The Affiliated Hospital of Putian University, Putian University, Putian, China
- Department of Women Health Care, Putian Maternity and Child Health Care Hospital, Putian, China
| |
Collapse
|
5
|
Wang Q, Xu M, Zhou H, Li Y, Ma J, Zhu X, He W. Prevalence characteristics of cervical human papillomavirus infection in Chengdu and Aba District, Sichuan Province, China. PLoS One 2024; 19:e0304760. [PMID: 38870122 PMCID: PMC11175428 DOI: 10.1371/journal.pone.0304760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/19/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE The genotype distribution of human papillomavirus (HPV) infection varies greatly in different regions. This study aims to determine the prevalence and type-specific distribution of HPV among females from Chengdu and Aba in Sichuan Province, which differ in geographical location, economic status, and living habits. These can serve as evidence of epidemic patterns for future design and implementation of vaccination and screening programs. METHODS A retrospective cross-sectional study was conducted on 144 113 women who underwent cervical screening at Chengdu Women's and Children's Central Hospital from January 2015 to September 2020. Meanwhile, 1799 samples from February 2018 to December 2021 were collected from Aba Maternal and Child Health Hospital. HPV DNA genotype testing was performed using real-time PCR. The overall prevalence, annual trend, age-specific prevalence, and type distribution were analyzed. RESULTS The overall HPV prevalence was 22.51% in Chengdu. During 2015-2020, the highest prevalence rate was observed in 2018. Age-specific HPV distribution displayed a bimodal distribution among women aged ≤25 or ≥46 years old. The top three prevalent genotypes were HPV52, -16, and -58. Although the total prevalence of HPV in Aba was 14.23%, there was an upward trend from 2018 to 2021. However, no significant differences were identified in HPV infection rate across all age groups. HPV52, -53, and -16 were the major genotypes. Furthermore, single-type HPV infections and high-risk HPV infections were identified as the most common infection types in both regions. CONCLUSION Our findings demonstrate the overall prevalence of HPV was still high in Chengdu and Aba. The age-specific prevalence distribution demonstrated different patterns. Non-vaccine-covered HR-HPV53, -51and LR-HPV81, -CP8304 were frequently detected, which was worth significant clinical attention. In summary, regional HPV screening provides valuable clinical guidance for cervical cancer prevention and vaccine selection in Western China.
Collapse
Affiliation(s)
- Qianqian Wang
- Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Min Xu
- Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hua Zhou
- Department of Clinical Laboratory, Aba Maternal and Child Health Hospital, Aba, China
| | - Yahui Li
- Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jichun Ma
- Department of Clinical Laboratory, Aba Maternal and Child Health Hospital, Aba, China
| | - Xuan Zhu
- Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Weijun He
- Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
6
|
Yao X, Li Q, Chen Y, Du Z, Huang Y, Zhou Y, Zhang J, Wang W, Zhang L, Xie J, Xu C, Ge Y, Zhou Y. Epidemiology of human papillomavirus infection in women from Xiamen, China, 2013 to 2023. Front Public Health 2024; 12:1332696. [PMID: 38590815 PMCID: PMC11000419 DOI: 10.3389/fpubh.2024.1332696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
Background Cervical cancer is primarily caused by HPV infection. The epidemiology of HPV infection in specific areas is of great meaning of guide cervical cancer screening and formulating HPV vaccination strategies. Here, we evaluated the epidemiological characteristics of HPV infection in Xiamen population. Methods In total, 159,049 cervical exfoliated cell samples collected from female outpatients in Women and Children's Hospital, School of Medicine, Xiamen between January 2013 and July 2023 were analyzed. HPV DNA detection was performed using HPV genotyping kits (Hybribio Limited Corp, China). An analysis was conducted on the prevalence of HPV infection, taking into account factors such as age, year, and multiple patterns of HPV infection. The differences in prevalence among age groups and years were compared using χ2 test. Results The overall prevalence of any 21 HPV genotypes was 18.4%, of which the high-risk HPV (HR-HPV) positive rate was 14.6%. The age-specific prevalence of HPV infection showed a bimodal distribution, with two distinct peaks, one at <25 years (31.2%) and the other at 60-64 years (32.9%). There was a downward trend in the prevalence of HPV infection over time, decreasing from 26.2% in 2013 to 14.5% in 2021, and then increasing to 19.0% in 2023. The five most prevent HR-HPV genotypes were HPV52 (4.0%), 58 (2.6%), 16 (2.5%), 51 (1.8%), and 39 (1.7%). Among the positive cases, 76.7% were detected with only one genotype and 23.3% with multiple genotypes. The most common co-infection was HPV52 + HPV58 (0.24%), followed by HPV16 + HPV52 (0.24%), HPV52 + HPV53 (0.21%), HPV52 + HPV81 (0.21%), HPV51 + HPV52 (0.19%), HPV16 + HPV58 (0.18%), and HPV39 + HPV52 (0.17%). Conclusion The study provided the largest scale information on the recent epidemiological characteristics of HPV infection in Xiamen, and even in Fujian Province, China, which would support making the prevention and control strategies for cervical cancer in the region.
Collapse
Affiliation(s)
- Xingmei Yao
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Qing Li
- Department of Women Health Care, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yu Chen
- United Diagnostic and Research Center for Clinical Genetics, Women and Children’s Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Zhuowen Du
- United Diagnostic and Research Center for Clinical Genetics, Women and Children’s Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yanru Huang
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yixi Zhou
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jian Zhang
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Wenbo Wang
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Lutan Zhang
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Jieqiong Xie
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Chao Xu
- Department of Information Center, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yunsheng Ge
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yulin Zhou
- Department of Central Laboratory, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China
- United Diagnostic and Research Center for Clinical Genetics, Women and Children’s Hospital, School of Medicine and School of Public Health, Xiamen University, Xiamen, Fujian, China
| |
Collapse
|
7
|
Zhang J, Zha T, Wang X, He W. Prevalence and genotype distribution of HPV infections among women in Chengdu,China. Virol J 2024; 21:52. [PMID: 38429823 PMCID: PMC10908056 DOI: 10.1186/s12985-024-02317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Human papilloma virus (HPV) infection among female is the cause of cervical cancer and genital warts. In China, the HPV vaccination rate and the target population screening rate among females are low, and the aims of this study on the genotype distribution and prevalence of HPV infection were to provide more targeted strategies for the prevention and treatment of cervical cancer and HPV-related diseases. METHODS Polymerase chain reaction-reverse dot blot (PCR-RDB) was adopted for HPV genotyping test, the prevalence and 23 genotypes distribution of HPV infections among 181,705 women in Chengdu from 2013 to 2020 were analysed. RESULTS The overall prevalence rate of HPV infection among 181,705 cases was 23.28%, the prevalence of HR-HPV at the age group < 20 years, 60-69 years and ≥ 70 years were higher than the overall prevalence.The prevalence of HPV showed a bimodal U-shaped curve with age; the first and second peak common occurred among females < 20 years old (42.97%) and 60-69 years old (37.56%), respectively.The top five genotypes of HPV infection among females in Chengdu were HPV52/16/58/81/53. Single infection (73.26%) was the main HPV infection pattern, followed by double infection (19.17%) and multiple infection (7.57%), the infection rate of HPV showed a gradual declined as the patterns of HPV coinfections increased, low-risk and high-risk coinfection was higher in low-risk HPV infection (43.68%) and lower in high-risk HPV infection (13.59%). The prevalence of genotypes - 6 and - 81 infection was the second highest at the age group of 20 and 40-59, respectively, while the prevalence of HPV16 was the highest at the age group of ≥ 70 among 23 genotypes among the 181,705 women. CONCLUSIONS The prevalence of HPV infections among women in Chengdu is higher than domestic certain developed citys, among the five vaccines available, nonavalent vaccine is more suitable for Chengdu females. For young females prioritizing vaccination is essential in the current context.Double screening for HPV DNA is important in middle-aged women (30-49 years), and screening should not be lacking in older women (> 65 years). Additionally,for patients with genital warts, it is necessary to screen for high-risk HPV infection and provide appropriate management and treatment. Given the limitations of this study, future HPV research should aim to achieve full coverage of the target population, and our studies should also include cellular or pathological data of HPV-positive cases, vaccination rates, and various lifestyle details.
Collapse
Affiliation(s)
- Junying Zhang
- Clinical Laboratory Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Tianzhi Zha
- Chengdu Angel medical equipment Co., LTD, Chengdu, China
| | - Xuemei Wang
- Clinical Laboratory Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Weijun He
- Clinical Laboratory Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| |
Collapse
|
8
|
Wang S, Liu S, Tan S, Yin J, Li Y, Zhao F, Qiao Y. Characteristics of human papillomavirus prevalence and infection patterns among women aged 25-64 according to age groups and cytology results in Ordos City, China. Virol J 2024; 21:12. [PMID: 38191450 PMCID: PMC10775550 DOI: 10.1186/s12985-023-02240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The assessment of human papillomavirus (HPV) genotype distribution in terms of age and cervical lesions could contribute to the adoption of more targeted preventive approaches to specific populations against cervical cancer. The current study was conducted in Ordos City, China, with the aim of analyzing the HPV genotypes prevalence and infection patterns within a hospital-based population. METHODS The analysis included a total of 26,692 women aged 25-64 who underwent cervical cancer screening between January 1st, 2019, and June 30th, 2022, in Ordos City. These women had valid results for both the polymerase chain reaction (PCR)-reverse dot blot (RDB) HPV test and the liquid-based cytology (thinprep cytologic test/TCT). Data were extracted from the database of KingMed Diagnostics laboratories. The prevalence of HPV genotypes within different age groups and cytology diagnoses were calculated. RESULTS Among 26,692 women, 7136 (26.73%) women were HPV positive, 5696 (21.34%) women were high-risk HPV (HR-HPV) positive, and 2102 (7.88%) women had multiple HPV infections. The most frequently detected HPV genotypes were HPV16 (4.72%) and HPV52 (4.15%), ranking as the first and second most prevalent genotypes, respectively. The prevalence of HR-HPV increased with age groups and severity of cervical lesions. Notably, the positive rate of HR-HPV among women aged 35-64 years showed a decreasing trend over the respective years, ranging from 26.00 to 19.70% (Ptrend < 0.001). CONCLUSION In conclusion, the epidemiology of HPV genotypes partly reflects the effectiveness of regional cervical cancer prevention and control efforts in the past. These findings can inform future initiatives concerning HPV vaccination and screening in the region.
Collapse
Affiliation(s)
- Sumeng Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Shujun Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Sensen Tan
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Jian Yin
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yufei Li
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, 361102, Fujian, China
| | - Fanghui Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Youlin Qiao
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| |
Collapse
|
9
|
Gao Y, Zhang M, Zheng Y, Huang H, Xie H. Human Papilloma Virus Infection and Gene Subtypes Analysis in Women Undergoing Physical Examinations: A 2015-2020 Study in Wenzhou, China. Cancer Control 2024; 31:10732748241257902. [PMID: 38783796 PMCID: PMC11119376 DOI: 10.1177/10732748241257902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/12/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Persistent infection with high-risk human papillomavirus (HPV) is closely related to cervical cancer. The epidemiologic characteristics of cervical HPV have regional differences. Therefore, it is necessary to develop the most favorable policies according to the actual situation of each region to prevent and reduce the prevalence of cervical cancer. This retrospective cross-sectional study investigated the prevalence, gene subtypes, and temporal trends of HPV in women undergoing physical examination in Wenzhou, to provide a decision-making basis for further prevention and control of HPV. METHODS A total of 31 131 cervical exfoliated cell specimens obtained from physical examinations in Wenzhou, a coastal city of China, from 2015 to 2020 were collected. The age distribution was analyzed using the chi-squared test, and the time change trend was analyzed using the Mann-Kendall trend test. On this basis, the distribution characteristics of the HPV subtypes were analyzed. RESULTS The total prevalence rate was 9.55%, and the prevalence rate in different age groups ranged from 7.77% to 14.16%. The prevalence rate in different years was 8.84%-11.83%. The prevalence rate was bimodal; it was highest in the group 25 years old, followed by the group >61 years old. The top five high-risk gene subtypes were HPV52, HPV58, HPV53, HPV16, and HPV39, whereas the low-risk subtypes were HPV61, HPV81, HPV44, HPV43, and HPV55. Of all the positive samples, 76.03% were infected with a high-risk subtype. CONCLUSION Most female HPV patients in Wenzhou are infected with high-risk gene subtypes. Therefore, physical examination and screening for HPV should be further strengthened, and the corresponding vaccination policy should focus on high-risk gene subtypes.
Collapse
Affiliation(s)
- Yang Gao
- Research Institute of Health Development Strategies, Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
| | - Mengqi Zhang
- Hospital-Acquired Infection Control Department, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yuanyuan Zheng
- Department of Pathology, Wenzhou People’s Hospital, Wenzhou, China
| | - Hong Huang
- Zhejiang Provincial Key Laboratory of Watershed Sciences and Health, Wenzhou Medical University, Wenzhou, China
| | - Hongli Xie
- Institute for Public Policy and Social Development, Wenzhou Medical University, Wenzhou, China
- The First Clinical College of Medicine and the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
10
|
Yang X, Li Y, Tang Y, Li Z, Wang S, Luo X, He T, Yin A, Luo M. Cervical HPV infection in Guangzhou, China: an epidemiological study of 198,111 women from 2015 to 2021. Emerg Microbes Infect 2023; 12:e2176009. [PMID: 36744409 PMCID: PMC9936994 DOI: 10.1080/22221751.2023.2176009] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Persistent high-risk human papillomavirus (HPV) infection is the pivotal cause of cervical carcinogenesis. HPV types distribution varies greatly by region, and its long-term changes of prevalence remain to be fully characterized in China. Here, the largest population of 198,111 consecutive women who underwent routine cervical screening were investigated from 2015 to 2021 in Guangzhou, south China. The results showed that the overall HPV prevalence was 21.66% (42,911/198,111), and the annual prevalence increased significantly from 2015 to 2021 (p < 0.001). HPV52, 16, 58, CP8304, 51, 53, 39, and 68 were the most prevalent HPV types. The relative HPV-positive rate correlated positively with the progression of cervical intraepithelial neoplasia (p < 0.001); HPV16 was the predominant carcinogenic type, followed by HPV52 and HPV18. HPV infections were significantly age-specific, and 26.51% (11,375/42,911) of cases were caused by multiple HPV types. In addition, HPV infections typically cleared over a median time of 16 (interquartile range 9-31) months, and the clearance of HPV16 was significantly faster than that of other types (p < 0.001). These findings may serve as a guide for local governments to evaluate HPV vaccination and cervical cancer prevention strategies in south China.
Collapse
Affiliation(s)
- Xiaohan Yang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Yuanyuan Li
- Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yuan Tang
- Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Zhiyu Li
- Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Sanfeng Wang
- Department of Gynecology and Obstetrics, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Xiping Luo
- Department of Gynecology and Obstetrics, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Tianwen He
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China
| | - Aihua Yin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China,Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China, Mingyong Luo ; Aihua Yin
| | - Mingyong Luo
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China,Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, People’s Republic of China,Department of Clinical Laboratory, Guangdong Women and Children Hospital, Guangzhou, People’s Republic of China, Mingyong Luo ; Aihua Yin
| |
Collapse
|
11
|
Tang X, Zhang H, Wang T, Jiang W, Jones TE, He Y, Li L, Tong L, Wang C, Wang W, Yang K, Yin R, Zhao C. Single and Multiple High-Risk Human Papillomavirus Infections in Histopathologically Confirmed Cervical Squamous Lesions: Incidences, Distribution, and Associated Detection Rates for Precancerous and Cancerous Lesions. J Transl Med 2023; 103:100234. [PMID: 37574009 DOI: 10.1016/j.labinv.2023.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/02/2023] [Accepted: 08/05/2023] [Indexed: 08/15/2023] Open
Abstract
Coinfection with multiple high-risk human papillomavirus (hrHPV) is frequently observed in cervical specimens; however, the clinical significance of concomitant multiple hrHPV infections is poorly understood, and the published results remain inconsistent. A retrospective study at a tertiary care institution was performed, evaluating Tellgenplex human papillomavirus (HPV) 27 genotyping or YanengBio HPV 23 genotyping results and immediate cervical histologic diagnosis (within 6 months after HPV genotyping), between November 2015 and October 2022. Among 49,299 cases with hrHPV genotyping and histologic diagnosis, 24,361 cases were diagnosed as cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma. Among women with cervical squamous lesions, 86.5% (21,070/24,361) had hrHPV infections, and concomitant multiple hrHPV infections accounted for 24.7% of hrHPV-positive cases (5210/21,070). The hrHPV-positive rates in these cervical squamous lesions increased progressively with disease severity; however, the percentages of concomitant multiple hrHPV infection rates among hrHPV-positive cases decreased significantly with increasing degree of squamous abnormalities. There was no increased detection rate of CIN3+ (CIN3 and squamous cell carcinoma) in cases with concomitant 2 or 3 hrHPV genotype infections when compared with those with corresponding single hrHPV infections. Conversely, some combinations of multiple hrHPV infections demonstrated a decrease in the detection rates of CIN3+ lesions. In this large cohort, our results demonstrated that multiple hrHPV infections do not carry an increased risk for developing CIN3+ lesions when compared to the corresponding single-genotype infection. The reduced risk of CIN3+ in women infected with some combinations of hrHPV genotypes compared to those with single-genotype infections supports the concept of intergenotypic competition of hrHPV genotypes in cervical squamous lesions.
Collapse
Affiliation(s)
- Xiao Tang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Huina Zhang
- Department of Pathology, University of Rochester Medical Center, Rochester, New York
| | - Tiannan Wang
- Department of Pathology, University of Southern California, Los Angeles, California
| | - Wei Jiang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
| | - Terri E Jones
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Yanmei He
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Lei Li
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Lingling Tong
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Cheng Wang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Wei Wang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Kaixuan Yang
- Department of Pathology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Rutie Yin
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| |
Collapse
|
12
|
Liu M, Zhang X, Guo L, Sun W, Jiang X. HPV prevalence and genotype distribution among 38 056 women in Weifang, China: a cross-sectional study. BMJ Open 2023; 13:e073332. [PMID: 37669845 PMCID: PMC10481741 DOI: 10.1136/bmjopen-2023-073332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/20/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) infection is closely associated with cervical cancer, especially the persistent infection of high-risk HPV (HR-HPV) genotypes. Therefore, investigating the HPV prevalence, age-specific, genotype distribution and the impact of the COVID-19 pandemic among large populations was essential for HPV screening and optimising vaccination. DESIGN This was a cross-sectional study. METHODS A total of 38 056 cervical epithelial cell specimens were collected in Weifang city from January 2018 to December 2022. The study was divided into seven age groups based on the age of the participants. HPV genotype testing was performed by using a commercial kit which is designed for the detection of 23 HPV genotypes. RESULT A total of 8998 women were infected with HPV, with an overall positive rate of 23.64% (8998/38 056). Single infection of HPV was dominant among different age groups, which accounted for 71.33% of total infections. The most prevalent genotype was HR-HPV 16 (4.33%), followed by 52, 58, 53 and 68. Low-risk HPV (LR-HPV) 42 exhibited the highest prevalence (2.19%) among six LR-HPV genotypes, representing a novel finding. There was a significant difference in the prevalence across different age groups (p<0.01), with the highest prevalence in the group under 25 years old. During the 3 year COVID-19 breakout period, the number of HPV samples received in 2020, 2021 and 2022 was reduced by 24.03%, 14.79% and 24.76%, respectively. In 2018-2022, the annual prevalence varied between 21.09% and 25.30%, with a decreasing trend, while the prevalence of HR-HPV 39, 56, 31 and LR-HPV 42 increased. CONCLUSION This study indicates a high-HPV infection rate and age-specific distribution characteristics of HPV genotype infections, as well as analyses of the impact of the COVID-19 outbreak on the HPV prevalence, which provides an epidemiological basis for the control and prevention of HPV infection in this region.
Collapse
Affiliation(s)
- Mengmeng Liu
- Department of Clinical Laboratory, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Xuguang Zhang
- Department of Clinical Laboratory, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Lulu Guo
- Department of Clinical Laboratory, Affiliated Hospital of Weifang Medical University, Weifang, China
- College of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Wanli Sun
- Department of Clinical Laboratory, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Xuanli Jiang
- Department of Clinical Laboratory, Affiliated Hospital of Weifang Medical University, Weifang, China
| |
Collapse
|
13
|
Chen G, Gao L, Zheng P, Liu Y, Li P, Liu H. Prevalence and Genetype Distribution of Human Papillomavirus in Women with Condyloma Acuminatum in Henan Province, Central China. Infect Drug Resist 2023; 16:4919-4928. [PMID: 37534063 PMCID: PMC10393019 DOI: 10.2147/idr.s418783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose This study aims to analyze the distribution of human papillomavirus (HPV) genotypes and the associations of demographic characteristics with HPV infection among women with condyloma acuminatum (CA) in Henan Province of China. Methods From January 2019 to October 2022, 702 women with CA were sampled for HPV subtypes and surveyed by questionnaire at Henan Provincial People's Hospital. The HPV genotype was tested by flow-through hybridization after polymerase chain reaction (PCR). Results The location of warts was mainly vulva. The age of the subjects was mainly distributed in the 20-29-year-old, followed by 30-39-year-old. The most common subtypes were HPV 6 (43.59%), 11 (24.93%), 16 (11.82%), 52 (7.83%), 58 (7.55%), 51 (7.26%), 61 (5.70%), 39 (5.56%), 18 (5.13%), and 54 (4.70%), our results also suggested that HPV 6 and 11 were the dominant genotypes in each age group. The infection of low-risk HPV (LR-HPV) (74.50%) and single HPV (47.01%) were the main categories. In terms of educational level, women with senior high school or above were inclined to infect single and pure-LR HPV. Unmarried status, sometimes or never condom use increased the chances of multiple, pure high-risk (HR) and mixed HPV infections. Women with multiple sex partners were more likely to cause multiple and mixed HPV infections. Conclusion Our experimental data on the prevalence and subtype distribution of HPV in women with CA could provide valuable reference for preventing CA in Henan Province. The application of the nine-valent vaccine provides a broad prospect for female CA prevention.
Collapse
Affiliation(s)
- Guanghui Chen
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| | - Lan Gao
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| | - Peiming Zheng
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| | - Yanhong Liu
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| | - Pan Li
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| | - Huifang Liu
- Department of Clinical Laboratory, Henan Provincial People′s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, People’s Republic of China
| |
Collapse
|
14
|
Li M, Zhao C, Zhao Y, Li J, Wei L. Immunogenicity, efficacy, and safety of human papillomavirus vaccine: Data from China. Front Immunol 2023; 14:1112750. [PMID: 36993948 PMCID: PMC10040563 DOI: 10.3389/fimmu.2023.1112750] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/27/2023] [Indexed: 03/15/2023] Open
Abstract
The incidence rate and mortality rate of cervical cancer have steadily increased in young women in China. Therefore, it is critical to improve HPV vaccination rates, particularly for the younger population. There are currently five types of prophylactic vaccines in China: bivalent HPV vaccine (AS04-HPV-16/18), quadrivalent HPV vaccine, 9-valent HPV vaccine, homemade Escherichia coli-produced HPV bivalent vaccine, and Pichia pastoris produced HPV bivalent vaccine. All these five HPV vaccines have completed relevant clinical trials in China, and have been proven to be generally well-tolerated and immunogenic, efficacious against persistent HPV-related infections and genital precancerous lesions (data for 9-valent HPV vaccine is absent), and have demonstrated acceptable safety profiles, as previously shown in global studies. Given that the HPV vaccination rate in China is still very low, additional HPV vaccine coverage is needed to reduce the incidence and mortality rates of cervical cancer.
Collapse
Affiliation(s)
- Mingzhu Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Chao Zhao
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Yun Zhao
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Jingran Li
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Lihui Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| |
Collapse
|
15
|
Zhang W, Guo N, Li B, Shang E, Wang J, Zhang M, Yang X. Prevalence and genotype distribution of human papillomavirus infections in Beijing, China between 2016 and 2020. Virol J 2023; 20:11. [PMID: 36653807 PMCID: PMC9847084 DOI: 10.1186/s12985-023-01959-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Certain types of human papillomavirus (HPV) induce long-lasting infections that cause cervical cancer. This study evaluated the prevalence of HPV infections and the distribution of their genotypes among clinic patients and healthy women in Beijing, China. METHODS Cervical specimens were collected from 12,100 patients and 1176 subjects who underwent physical examinations at Dongzhimen Hospital, Beijing University of Chinese Medicine, between March 2016 and September 2020. HPV genotyping was performed using commercial kits designed to detect 15 high-risk and 2 low-risk HPV genotypes. RESULTS There was a higher overall prevalence of HPV among the clinic patients (21.0%) than among the healthy women (11.9%). The most common HPV genotypes among the patients were: HPV-52 (5.4%), HPV-16 (3.4%), HPV-58 (3.2%), HPV-51 (2.6%), HPV-39 (2.0%), HPV-56 (2.0%), and HPV-66 (2.0%). Among the healthy women: HPV-52 (3.0%), HPV-51 (1.8%), HPV-58 (1.6%), HPV-66 (1.5%), HPV-16 (1.2%), HPV-56 (1.2%), and HPV-18 (1.1%). Multiple HPVs were detected in 29.1% of the gynecological outpatients and in 23.6% of the women receiving physical examinations. The most common pairs of HPV types detected were HPV-52 and HPV-16 in the clinic patients, and HPV-52 and HPV-56 in the healthy women. Age-specific HPV positivity and peak prevalence were observed among the individuals in both groups for women aged less than 25 years and those between 61 and 65 years of age. CONCLUSIONS Our results provide current estimates of HPV prevalence and genotypes in the Beijing region. The epidemiological characteristics observed also provide a reference for the development of cervical cancer screening strategies and selection of HPV vaccine antigen targets for this region. A comparison of these HPV prevalence data with those from other regions suggests that regional vaccines may be an important direction for future research.
Collapse
Affiliation(s)
- Wei Zhang
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - Nan Guo
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - Baoping Li
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - E Shang
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - Jinxia Wang
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - Mei Zhang
- grid.24695.3c0000 0001 1431 9176Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700 China
| | - Ximing Yang
- Department of Clinical Laboratory, Dongzhimen Hospital, Beijing University of Chinese Medicine, No. 5, Haiyuncang, Dongcheng District, Beijing, 100700, China.
| |
Collapse
|
16
|
Zhang M, Chen G, Dai X, Wu Z, Huang H, Zheng Y. Prevalence of human papillomavirus in Wenzhou, China: a cross-sectional study of 127 938 outpatient women. BMJ Open 2022; 12:e066698. [PMID: 36581425 PMCID: PMC9806085 DOI: 10.1136/bmjopen-2022-066698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Understanding the prevalence and genotype distribution of human papillomavirus (HPV) is critical for managing HPV vaccination programmes. Using a retrospective cross-sectional study, we examined long-term trends of HPV prevalence in Wenzhou, a coastal city in China. SETTING AND PARTICIPANTS Cervical exfoliated cells were collected from 127 938 women who underwent cervical cancer screening at the gynaecology outpatient clinic of Wenzhou People's Hospital from January 2011 to December 2020. HPV infections and genotypes were determined. The HPV genotypes were 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 6, 11, 42, 43, 44 and 81. From 2011 to 2014, we used PCR and inflow hybridisation for typing assays. In 2015-2020, HPV genotyping was performed on the collected specimens using PCR and flow fluorescence hybridisation. RESULTS The overall prevalence of HPV infection was 17.8%. Across age groups, the prevalence fluctuated between 15.9% and 37.4%, with two peaks in the ≤20 and ≥51 year groups. The annual prevalence varied between 12.2% and 28.8%, with a significant decrease in 2011-2018 and a flat trend in 2018-2020. The five most common HPV genotypes were HPV52 (3.6%), 16 (3.0%), 58 (2.5%), 53 (1.9%) and 81 (1.3%). The prevalence of high-risk gene subtypes HPV56, 59 and the low-risk subtype HPV44 increased. Single HPV infection was the most common. CONCLUSION The prevalence of HPV in Wenzhou is low to mid-range; however, the high-risk genetic subtypes HPV56 and 59 have increased in recent years. We need to promote HPV vaccination and increase education regarding safer sex.
Collapse
Affiliation(s)
- Mengqi Zhang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Gang Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xuchao Dai
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Zhigang Wu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Huang
- Zhejiang Provincial Key Laboratory of Watershed Sciences and Health, Wenzhou Medical University, Wenzhou, China
| | - Yuanyuan Zheng
- Department of Pathology, Wenzhou People's Hospital, Wenzhou, China
| |
Collapse
|
17
|
Zhou Z, Hou Y, Qing W, Shi Y, Zhang Y, Chen R, Ou J, Zhou H, Chen M. The association of HPV infection and vaginal microbiota of reproductive women in China: A multicenter cohort study protocol. MEDICINE IN MICROECOLOGY 2022. [DOI: 10.1016/j.medmic.2022.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
18
|
Chen Y, Li S, Zheng J, Xue H, Chen J, Zheng X. Prevalence of multiple human papillomavirus infections and association with cervical lesions among outpatients in Fujian, China: A cross-sectional study. J Med Virol 2022; 94:6028-6036. [PMID: 35945897 DOI: 10.1002/jmv.28062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/19/2022] [Accepted: 08/05/2022] [Indexed: 01/06/2023]
Abstract
Multiple human papillomavirus (HPV) infections are common, but their impact on cervical lesions remains controversial. A total of 6225 female patients who underwent colposcopies/conization following abnormal cervical cancer screening results were included in the study. The final pathological diagnosis was determined by the most severe pathological grade among the cervical biopsy, endocervical curettage, and conization. Univariate and multivariate logistic regression analyses were used to investigate the association between multiple HPV infections and cervical lesions, adjusting for age, HPV genotype, gravidity and parity. In total, 33.3% (n = 2076) of the study population was infected with multiple HPV genotypes. Multiple HPV infections were more prevalent in patients younger than 25 years and older than 55 years, with the rate of multiple HPV infections at 52.8% and 44.3%, respectively. HPV16\52\18\58 are the most common HPV genotypes and usually appear as a single infection. Compared to single HR-HPV infection, multiple HR-HPV infections do not increase the risk of HSIL+, while single HR-HPV coinfected with LR-HPV seems to reduce the risk of HSIL+ (odds ratio = 0.515, confidence interval: 0.370-0.719, p < 0.001). Multiple HR-HPV infections cannot be risk-stratified for triage of HR-HPV-positive women.
Collapse
Affiliation(s)
- Yusha Chen
- Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Suyu Li
- Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Jinwen Zheng
- Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Huifeng Xue
- Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Jiancui Chen
- Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Xiangqin Zheng
- Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| |
Collapse
|
19
|
Yang Z, He ZH, Zhang Y, Di XH, Zheng DF, Xu HH. Genetic variability in the E6 and E7 oncogenes of HPV52 and its prevalence in the Taizhou area, China. Virol J 2022; 19:194. [PMID: 36415002 PMCID: PMC9682741 DOI: 10.1186/s12985-022-01929-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Human papillomavirus (HPV) 52 is one of the prevalent oncogenic HPV genotypes in East Asia. Chinese women have the highest susceptibility to the HPV52 type, but research data on HPV52 genetic variability and its carcinogenicity in China is lacking. Methods The present study aimed to investigate the genetic variability of HPV52 currently circulating among Chinese women by PCR sequencing the entire E6 and E7 oncogenes. HPV52 sequence alignment, genetic heterogeneity analyses and maximum-likelihood phylogenetic tree construction were performed by BioEdit software and MEGA X software. Results Between 2016 and 2018, the overall HPV infection rate was 21.3%, of which HPV52 was the most prevalent high-risk type (17.2%) in the Taizhou area, China. A total of 339 single HPV52-positive samples were included in this study. We obtained 27 distinct variation patterns of HPV52 with the accession GenBank numbers ON529577-ON529603. Phylogenetic analysis showed that 96.6% of HPV52 variants belonged to lineage B, which seemed to be uniquely defined by G350T, A379G (K93R) in the E6 gene and C751T, A801G in the E7 gene. Due to the dominance of lineage B in our study population, the results could not be used to assess the association of the HPV52 (sub)lineage with the risk of cervical lesions. In addition, no significant trends were observed between the nucleotide substitutions of HPV52 variants and the risk of cervical carcinogenesis. Conclusion Our data showed that HPV52 variants were strongly biased towards lineage B. These results confirmed that cervical lesions in the Taizhou area are highly attributable to HPV52, which may be due to the high infection rate of lineage B in the population. Supplementary Information The online version contains supplementary material available at 10.1186/s12985-022-01929-5.
Collapse
Affiliation(s)
- Zhi Yang
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| | - Zhe-Hang He
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| | - Yang Zhang
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| | - Xing-Hong Di
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| | - Die-Fei Zheng
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| | - Hui-Hui Xu
- grid.268099.c0000 0001 0348 3990Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China ,grid.268099.c0000 0001 0348 3990Scientific Research Department, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000 Zhejiang China
| |
Collapse
|
20
|
Zhuang L, Weng X, Wang L, Xie X, Zhong L, Liu D, Xiu Y. Performance of the Human Papillomavirus E6/E7 mRNA Assay in the Primary Screening of Cervical Cancer: Opportunistic Screening in Fujian, China. Int J Womens Health 2022; 14:1519-1530. [PMID: 36317009 PMCID: PMC9617522 DOI: 10.2147/ijwh.s383431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose A high-risk human papillomavirus E6/E7 mRNA (HR-HPV mRNA) assay is widely used in cervical cancer screening in China. However, it is still unclear whether stand-alone HR-HPV mRNA testing is sufficient for primary screening. The purpose of this study was to investigate the feasibility of a stand-alone HR-HPV mRNA assay for primary screening of cervical cancer. Methods Women aged 21 and older were recruited in Fujian Province, China, from January 2020 to January 2022. Cervical exfoliated cells were collected for cervical cytology and HR-HPV mRNA assays, and women with positive results on either assay were referred for colposcopy. The screening effectiveness of the assay was calculated based on the cervical histology. When comparing the efficacy of the different screening strategies, only women aged 25 and older were included. Results A total of 9927 women were recruited. This study identified 217 cases of high-grade squamous intraepithelial disease or worse (HSIL+). The overall age-specific HR-HPV infection rate showed a U-shaped distribution. The sensitivity of the HR-HPV mRNA assay to identify CIN2+ and CIN3+ was 97.2% and 97.9%, respectively, which was significantly higher than that of cytology (82.9% and 88.6%, P<0.001 and 0.002). The sensitivity of the HR-HPV mRNA primary screening strategy to identify CIN2+ and CIN3+ was 92.2% and 94.3%, respectively, which was similar to the co-testing strategy (P=0.336 and 0.394) and higher than the cytology primary screening (P=0.002 and 0.048). In addition, the HR-HPV primary screening strategy had a lower referral rate for colposcopy than cytology primary screening (5.4% vs 6.6%, P<0.001), and the screening cost was lower than co-testing ($29,594.3 per 1000 screened women vs $55,140 per 1000 screened women, P<0.001). Conclusion In conclusion, the detection of CIN2+/CIN3+ by HR-HPV mRNA is both specific and sensitive. It may be suitable for primary screening of cervical cancer in China.
Collapse
Affiliation(s)
- Lijuan Zhuang
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiulan Weng
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Lihua Wang
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiaoyan Xie
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Liying Zhong
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Dabin Liu
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Yingling Xiu
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China,Correspondence: Yingling Xiu; Dabin Liu, Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Fuzhou, People’s Republic of China, Tel +86-13860610354; +86-13489997701, Fax +86-591-87551247, Email ; ;
| |
Collapse
|
21
|
Yu YQ, Hao JQ, Mendez MJG, Mohamed SB, Fu SL, Zhao FH, Qiao YL. The Prevalence of Cervical HPV Infection and Genotype Distribution in 856,535 Chinese Women with Normal and Abnormal Cervical Lesions: A Systemic Review. J Cytol 2022; 39:137-147. [PMID: 36605868 PMCID: PMC9809425 DOI: 10.4103/joc.joc_42_22] [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: 02/24/2022] [Revised: 04/27/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
Cervical cancer is the commonest cancer affecting women worldwide. During the last decades, the incidence and mortality rates of cervical cancer have increased in China. This research aims to assess the overall and genotype-specific prevalence of the human papillomavirus (HPV) infection among Chinese women with normal cervix, considering age, and geographic location. We selected studies about HPV prevalence in women from Chinese in Mainland China with normal cervix and abnormal cervical lesions, published between January 1995 and December 2020. The HPV prevalence was analyzed using meta-analysis based on the following: cytological and histological diagnoses, regions, and ages. The overall HPV prevalence in 856,535 women was 14.3%, 95% confidence interval (CI) and it increased from 8.2% to 16.5% in studies published from 2006 to 2020. The prevalence of high-risk (HR) and low-risk (LR) HPV types was 11.3% and 2.7%, respectively. The commonest types of HPV in women from Mainland China were HPV 16 (2.6%), 52 (2.4%), 58 (1.7%), 18 (0.9%), and 33 (0.8%). According to the geographical analysis, the prevalence of different HPV genotypes varied by region, Central China had the highest overall HPV prevalence. HPV16 was the commonest type in all the regions except in South China and East China, where HPV52 was found to be common. Regarding diagnosis, the HPV infection led to cervical cancer diagnosis by cytology and histology with 90.1% and 91.5% rates, respectively. HPV16 and HPV18 were common types associated with cervical cancer diagnosed by cytology and histology. HPV 16, 58, 52, 18, and 33 were the commonest types found in women with normal cervixes from Mainland China. The prevalence of different HPV genotypes varied by age group and region.
Collapse
Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Jin-Qi Hao
- Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Maria J. G. Mendez
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Dalian Medical University, Dalian City, China
| | - S Bangura Mohamed
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Public Health and Preventive Medicine, Dalian Medical University, Dalian City, China
| | - Shi-Lan Fu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences and Peking Union Medical College School of Population Medicine and Public Health, Beijing, China
| |
Collapse
|
22
|
Si M, Su X, Jiang Y, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Liu Y, Qiao Y. An Internet-Based Education Program for Human Papillomavirus Vaccination Among Female College Students in Mainland China: Application of the Information-Motivation-Behavioral Skills Model in a Cluster Randomized Trial. J Med Internet Res 2022; 24:e37848. [PMID: 36178723 PMCID: PMC9568820 DOI: 10.2196/37848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/28/2022] [Accepted: 09/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Patients diagnosed with cervical cancer in the last 2 decades were mainly young females. Human papillomavirus (HPV) vaccination is the most radical way to prevent HPV infection and cervical cancer. However, most female college students in mainland China have not yet been vaccinated, and their relevant knowledge is limited. Theory-based education delivered via the internet is a potentially accessible and useful way to promote HPV vaccination among this population. OBJECTIVE This 3-month follow-up study intended to identify the feasibility and efficacy of an information-motivation-behavioral skills (IMB) model-based online intervention for promoting awareness and willingness regarding HPV vaccination among female college students. METHODS A 7-day online HPV education program for female college students in mainland China was developed using a cluster randomized trial design. Recruitment and questionnaire surveys were performed online without face-to-face contact. SPSS 23.0 was used for statistical analysis. The chi-square test and t test were used to compare differences in qualitative and continuous variables between intervention and control groups. The generalized estimating equation was used to test the effectiveness of the intervention with a consideration of the time factor. RESULTS Among 3867 participants, 102 had been vaccinated against HPV before the study (vaccination rate of 2.6%). A total of 3484 participants were followed up after the baseline survey, with no statistical difference in the loss rate between the intervention and control groups during the intervention and follow-up periods. At different follow-up time points, HPV-related knowledge, and the motivation, behavioral skills, and willingness regarding HPV vaccination were higher in the intervention group than in the control group. HPV-related knowledge was statistically different between the 2 groups, while the motivation, behavioral skills, and willingness regarding HPV vaccination only showed statistical differences right after the intervention, reaching a peak right after the intervention and then gradually reducing over time. Furthermore, there was no statistical difference in the HPV vaccination rate between the 2 groups. CONCLUSIONS IMB model-based online education could be a promising way to increase the HPV vaccination rate and reduce the burden of HPV infection and cervical cancer among high-risk female college students in China. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900025476; http://www.chictr.org.cn/showprojen.aspx? proj=42672. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-DOI:10.1186/s12889-019-7903-x.
Collapse
Affiliation(s)
- Mingyu Si
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, China
| | - Jing Li
- West China School of Public Health, West China Forth Hospital, Sichuan University, Chengdu, China
| | - Shaokai Zhang
- Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zefang Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
23
|
Huang W, Xu H, Hu H, Zhang D, Liu Y, Guo Y, Xiao F, Chen W, Ma Z. The prevalence of human papillomavirus among women in northern Guangdong Province of China. Sci Rep 2022; 12:13353. [PMID: 35922661 PMCID: PMC9349279 DOI: 10.1038/s41598-022-17632-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023] Open
Abstract
Globally, cervical cancer, whose etiologic factor is Human papillomavirus (HPV), is the third most common cancer among women. In cervical cancer screening, HPV testing is important. However, the prevalence of HPV in northern Guangdong Province has not been conclusively determined. A total of 100,994 women attending Yuebei People's Hospital Affiliated to Shantou University Medical College between 2012 and 2020 were recruited. HPV was tested by a polymerase chain reaction (PCR)-based hybridization gene chip assay. The prevalence of HPV among these women was established to be19.04%. Peak prevalence was observed in women aged 40-49 (7.29%). Besides, the prevalence of single-type HPV infection (14.46%) was significantly high, compared to multiple-type infection (4.58%) (p < 0.01), while the prevalence of high-risk HPV infection (19.97%) was significantly higher than that of low-risk genotypes (5.48%) (p < 0.01). The most prevalent high-risk genotypes were HPV52 (4.16%), HPV16 (2.98%), HPV58 (2.15%), HPV53 (1.58%) and HPV68 (1.34%). HPV co-infection with up to 10 genotypes was reported for the first time. Our findings suggested a high burden of HPV infections among women in northern Guangdong. Establishing the prevalence and genotype distribution characteristics of HPV infections in the region can contribute to cervical cancer prevention through HPV vaccination.
Collapse
Affiliation(s)
- Wenbo Huang
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Hongyan Xu
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Hongbo Hu
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Dingmei Zhang
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yulan Liu
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Yanle Guo
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Fengjin Xiao
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Weijuan Chen
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| | - Zhanzhong Ma
- Yuebei People's Hospital, Shantou University Medical College, Shaoguan, 512026, China
| |
Collapse
|
24
|
Extensive HPV Genotyping Reveals High Association between Multiple Infections and Cervical Lesions in Chinese Women. DISEASE MARKERS 2022; 2022:8130373. [PMID: 35722626 PMCID: PMC9205720 DOI: 10.1155/2022/8130373] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/10/2022] [Accepted: 05/25/2022] [Indexed: 11/20/2022]
Abstract
Objective The relationship between human papillomavirus (HPV) and cervical lesions has been extensively elucidated, but infection with multiple genotypes is less investigated due to methodology limitations. In the current study, with a method of genotyping 21 HPVs in a routine cervical screening population, we aimed to investigate the prevalence and diversity of HPV infections in Chinese women and further evaluate the impact of multiple infections of HPV on cervical lesion progression. Methods Totally, 73,596 patients who underwent 21-genotype HPV testing from January 2018 to April 2019 were retrieved from the database of the Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University. HPV testing was performed by real-time PCR assay, including 13 high-risk HPVs (hrHPV), 5 potential hrHPVs, and 3 low-risk HPVs. Results Of the 17,079 (infection rate, 23.2%) hrHPV- or potential hrHPV- (hr/phrHPV-) positive cases, 26.3% had multiple infections. Women younger than 25 and older than 65 were more prone to multiple infections. Of the hr/phrHPV-positive cases involving cervical intraepithelial neoplasia (CIN) 2 or worse (CIN2+), HPV73, 53, and 66 (=59) were the top three genotypes most likely to be included in multiple infections, while HPV16, 18, and 58 were the 3 least. Patients with single infection of HPV16 had higher incidences of CIN2+ than those with multiple-infection pattern (P < 0.001), indicating that mixing with other genotypes alleviated pathogenicity. The infection of HPV52, 53, 56, 51, 39, 66, 59, 68, and 35 showed an opposite pattern, indicating that they were less likely to be pathogens individually. All other types showed no significant differences, indicating the capability of pathogenesis independently. HPV26 showed a higher OR for CIN2+ than most traditional hrHPV genotypes. The vial load and the percentage of HPV16 showed positive correlation with the severity of cervical lesions. Conclusion Extensive genotyping identified 3 most frequent genotypes, HPV16, 52, and 58, in CIN2+ of Chinese population. HPV16 mixing with other genotypes alleviated its pathogenicity. The vial load and the percentage of HPV16 were positively correlated with the severity of cervical lesions. HPV26 may be considered as a hrHPV, which needs to be evaluated and confirmed by more cases.
Collapse
|
25
|
Gu X, Sun G, Zheng R, Zhang S, Zeng H, Sun K, Wang S, Chen R, Wei W, He J. Incidence and mortality of cervical cancer in China in 2015. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:70-77. [PMID: 39034952 PMCID: PMC11256676 DOI: 10.1016/j.jncc.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To estimate the incidence and mortality of cervical cancer in China based on the cancer registration data in 2015, collected by the National Central Cancer Registry (NCCR). Methods There were 501 cancer registries that submitted data to the NCCR, whose data were the basis for estimating the incidence and mortality of cervical cancer in China in 2015. After evaluating the data quality, 368 registries' data were accepted for the analysis and stratified by area (urban/rural) and age group. Combined with data on the national population in 2015, the nationwide incidence and mortality of cervical cancer were estimated. Cervical Cancer cases of 22 cancer registries were applied for temporal trends from 2000 to 2015. The Chinese population census in 2000 and Segi's population were used to calculate age-standardized incidence and mortality rates. Results An estimated 111,000 new cases were attributed to cervical cancer in China in 2015, accounting for 6.24% of all female new cancer cases in that year in China. The crude rate (CR) of incidence and age-standardized incidence rates by the China standard population (ASIRC) and by Segi's world standard population (ASIRW) of cervical cancer were 16.56/100,000, 11.78/100,000, and 10.86/100,000, respectively. The cumulative incidence rate from birth to 74 years old was 1.15%, whereas the calculation of incidence rates over the truncated age range of 35-64 years by Segi's world standard population (T-ASIRW) was 27.66/100,000. The estimates of cervical cancer deaths were about 33,800 and 3.94% of all female cancer-related deaths in China in 2015, with a crude mortality rate of 5.04/100,000. The age-standardized mortality rates adjusted by the Chinese standard population (ASMRC) and by world Segi's population (ASMRW) were 3.29/100,000 and 3.15/100,000, respectively, with a cumulative mortality rate (0-74 years old) of 0.35%. Both the incidence and mortality were higher in rural than in urban areas. The age-specific cervical cancer incidence significantly increased with age, particularly after age 25 years, and peaked at 50-54 years old, whereas age-specific mortality increased rapidly after 35 years old, peaking at 80-84 years old. The age-standardized incidence rates increased by about 8.6 (95% CI: 6.9, 10.3) per year during the period of 2000-2015. The age at diagnosis of patients with cervical cancer tended to be younger. In rural areas, the mean age at diagnosis decreased about 3.22 years from 2000 to 2015 (β = -0.33, P < 0.001). Conclusions China has a high burden of cervical cancer and important disparities among different regions. Especially in the middle and western areas and rural areas, cervical cancer is a serious issue in women's health, and prevention strategies need to be enhanced. Prevention and control strategies need to be enhanced and implemented with reference to local status, such as human papillomavirus (HPV) vaccination and screening programs.
Collapse
Affiliation(s)
- Xiuying Gu
- Public Health Division, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Cancer Center, Urumqi 830011, Xinjiang, China
| | - Gang Sun
- The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Cancer Center, Key Laboratory of Oncology of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Siwei Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Kexin Sun
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaoming Wang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ru Chen
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| |
Collapse
|
26
|
Zeng Z, Austin RM, Wang L, Guo X, Zeng Q, Zheng B, Zhao C. Nationwide Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection in China. Am J Clin Pathol 2022; 157:718-723. [PMID: 34724029 DOI: 10.1093/ajcp/aqab181] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/16/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Extended high-risk human papillomavirus (hrHPV) genotype testing has recently been introduced in routine cervical cancer screening. Changes in national and regional hrHPV genotype prevalence offer an objective baseline indicator of the future impact of mass HPV vaccination and HPV-based cervical screening. METHODS This retrospective study reports nationwide hrHPV genotyping results from July 2018 to June 2019 in 29 KingMed Diagnostics laboratories throughout China. RESULTS In total, 2,458,227 hrHPV genotyping results were documented from KingMed's nationwide laboratory database during the study period. The overall prevalence of hrHPV-positive results was 19.1%, with twin peaks for highest hrHPV infection rates in women younger than 30 years of age (22.0%) and 50 years of age and older (21.8%). The most frequently detected hrHPV genotypes were HPV-52 (4.7%), HPV-16 (3.4%), HPV-53 (2.5%), HPV-58 (2.4%), HPV-51 (2.0%), and HPV-68 (1.6%). Overall, hrHPV-positive results varied regionally from 15.3% to 24.4%. CONCLUSIONS Nationwide hrHPV genotyping results from KingMed laboratories offer a baseline for measuring the future impact of large-scale HPV vaccination. High hrHPV infection rates in older (≥50 years) Chinese women likely reflect the limited extent of cervical screening in China. High rates of hrHPV infection and variable regional hrHPV genotype distribution may represent limiting factors for cost-effective implementation of hrHPV-based cervical screening in China.
Collapse
Affiliation(s)
- Zhengyu Zeng
- Department of Molecular Microbiology, KingMed Diagnostics, Guangzhou, China
| | - R Marshall Austin
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Lin Wang
- Department of Molecular Microbiology, KingMed Diagnostics, Guangzhou, China
| | - Xiaolei Guo
- Department of Molecular Microbiology, KingMed Diagnostics, Guangzhou, China
| | - Qiuqiong Zeng
- Department of Molecular Microbiology, KingMed Diagnostics, Guangzhou, China
| | - Baowen Zheng
- Department of Molecular Microbiology, KingMed Diagnostics, Guangzhou, China
| | - Chengquan Zhao
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|
27
|
Lin X, Chen L, Zheng Y, Yan F, Li J, Zhang J, Yang H. Age-specific prevalence and genotype distribution of human papillomavirus in women from Northwest China. Cancer Med 2022; 11:4366-4373. [PMID: 35365956 DOI: 10.1002/cam4.4732] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/26/2022] [Accepted: 03/21/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is the leading cause of cervical cancer with more than 200 genotypes. Different genotypes have different potentials in causing premalignant lesions and cervical cancers. In this study, we investigated the age-specific prevalence and genotype distribution of HPV genotypes in Northwest China. MATERIALS AND METHODS We recruited 145,918 unvaccinated women from Northwest China for population-based HPV DNA screening test during June 2015 to December 2020. And a lab-based test was performed for each volunteer by flow fluorescent technology to identify the genotypes of HPV. RESULTS The overall infection rate of HPV was 22.97%. With the participants divided into 12 groups according to age, a bimodal curve of infection rate was obtained. And the two peaks appeared in the younger than 20 group and 61-65 group, respectively. The five most common HPV genotypes included HPV 16, 58, 52, 53 and 61 in all participants, which were in descending order of frequency. Among women younger than 25 years old, HPV 6 and 11 were more common and even higher than some genotypes mentioned above. Among women older than 65 years old, HPV 18 and 66 were more common than or as high as the six most common genotypes in all populations. Additionally, the distribution of single and multiple infections in each age group was also different. CONCLUSION The baseline prevalence and genotype distribution of HPV in Northwest China was uncovered for the first time. Age was related to the epidemiology of different HPV genotypes. All the results would be of great significance for future healthcare services.
Collapse
Affiliation(s)
- Xiaohong Lin
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Liu Chen
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Yunyun Zheng
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Feng Yan
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Jia Li
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Jianfang Zhang
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| | - Hong Yang
- Department of Gynecology and Obstetrics, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, Shaanxi, China
| |
Collapse
|
28
|
Wang J, Dong J, Zhou Y, Wang K, Pan M, Deng Z, Wang P, Du Y, Lu W. Performance of human papillomavirus (HPV) mRNA testing and HPV 16 and 18/45 genotyping combined with age stratification in the triaging of women with ASC-US cytology. Gynecol Oncol 2022; 164:607-614. [PMID: 34996586 DOI: 10.1016/j.ygyno.2021.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study aimed to assess the clinical performance of an HPV E6/E7 mRNA assay (Aptima HPV, AHPV) and AHPV 16 18/45 genotype assay (AHPV-GT) combined with age stratification for triaging women with atypical squamous cells of undetermined significance (ASC-US) cytology. METHODS In total, 3052 women >21 years old with ASC-US cytology underwent AHPV testing, and AHPV-positive samples were reflex-tested with the AHPV-GT test. All women were referred for colposcopy and then biopsy if indicated. The AHPV and AHPV-GT test performances and risk estimates by hrHPV status with age stratification were calculated. RESULTS Overall, 1599 women (52.4%) tested AHPV positive; of these women, 225 (7.4%), 101 (3.3%) and 1273 (41.7%) tested HPV 16+, HPV 18/45+ and other hrHPV-genotype-positive. When identifying CIN3+, the AHPV test had a 93.2% sensitivity and achieved a higher NPV (99.7% vs. 98.5%, P < 0.001) but a lower PPV (4.3% vs. 10.4%, P < 0.001) than the AHPV-GT test. The immediate risks of CIN3+ in AHPV+, other hrHPV+, and AHPV-GT+ women were 4.3%, 2.7%, and 10.4%, respectively. In the 21-24-year-old group, the immediate risks were 1.6%, 2.0% and 0.0%, which were below the 4.0% threshold for immediate colposcopy. The immediate colposcopy referral rate for AHPV-positive/ASC-US women 25 years or older was reduced from 51.7% to 10.5% by the AHPV-GT risk stratification method. CONCLUSIONS AHPV testing with age stratification is effective for triaging women with ASC-US cytology. AHPV-GT testing may be a proper risk stratification method for women with AHPV-positive ASC-US cytology.
Collapse
Affiliation(s)
- Jiajian Wang
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Jie Dong
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Yinjian Zhou
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Kaiyi Wang
- Department of Cervical Disease, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Min Pan
- Department of Cervical Disease, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Zaixing Deng
- Department of Pathology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Pengfei Wang
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Ying Du
- Department of Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province, China
| | - Weiguo Lu
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China.
| |
Collapse
|
29
|
Zhang X, Chen H, Zhou J, Huang Q, Feng XY, Li J. Impact of web-based health education on HPV vaccination uptake among college girl students in Western and Northern China: a follow-up study. BMC Womens Health 2022; 22:46. [PMID: 35197068 PMCID: PMC8864209 DOI: 10.1186/s12905-022-01625-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/08/2022] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effect of a web-based educational intervention on changing female college students’ willingness and uptake of human papillomavirus (HPV) vaccines, and factors associated with HPV vaccination acceptance in Western and Northern China. Methods A web-based cluster randomized controlled trial was conducted in Western and Northern China from February to May 2020. A total of 967 female freshmen were recruited from two universities through convenience sampling, stratified sampling (liberal arts or sciences), and cluster sampling. Eligible students were randomized into intervention and control group with a 1:1 allocation ratio. The intervention group received seven days of web-based health education regarding HPV and HPV vaccines, whereas the control group received non-HPV-related materials. All students were asked to complete a post-intervention questionnaire to measure their awareness, uptake, and willingness to receive HPV vaccination at 7-day and one-month intervals. The chi-square test and Student’s t-test were employed to examine the differences between the intervention and control groups for categorical and continuous data. Logistic regressions were used to analyze factors associated with vaccination intentions. Results Nine hundred forty-six female freshmen aged 18.99 ± 0.63 years were enrolled in the study, with 532 in the intervention group and 414 in the control group. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. Only 2.2% of students reported being vaccinated, but 33.0% were willing to be vaccinated against HPV. After seven days of education, students in the intervention group exhibited higher awareness (p < 0.001) and knowledge scores (5.13 ± 1.23 vs. 3.10 ± 1.99, p < 0.001) than those in the control group. Similarly, in the intervention groups, willingness to be vaccinated against HPV was significantly higher than in the control groups (p < 0.001). The high cost (57.7%) and concerns about adverse events (56.0%) were the main reasons female college students did not accept HPV vaccines. School location in urban areas, parents’ higher education backgrounds, history of HPV vaccination counseling, history of sexual behavior, and having heard of HPV vaccines were associated with a higher willingness to be vaccinated. Conclusion Female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on HPV vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01625-0.
Collapse
Affiliation(s)
- Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hui Chen
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Jing Zhou
- Chenghua District Center for Disease Control and Prevention, Chengdu, 610057, China
| | - Qian Huang
- Student Affairs Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiao-Yu Feng
- Shanxi University of Finance and Economics, Taiyuan, 030006, China
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
30
|
Si M, Su X, Jiang Y, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Liu Y, Qiao Y. Effect of an IMB Model-Based Education on the Acceptability of HPV Vaccination Among College Girls in Mainland China: A Cluster RCT. Cancer Control 2022; 29:10732748211070719. [PMID: 35088609 PMCID: PMC8801631 DOI: 10.1177/10732748211070719] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective Despite the fact that the human papillomavirus vaccine (HPVV) has been approved in mainland China since 2016, there is a lack of inoculation among Chinese college women. This multi-center, online interventional RCT based on the information-motivation-behavioral skills (IMB) model intended to investigate if the intervention may improve human papillomavirus vaccine acceptance and awareness among target women. Methods Participants were selected from comprehensive universities and allocated to 1 of 2 groups: intervention or control. After the baseline survey, participants in the intervention group were given 10-minute online IMB model-based education every day for 7 days. Self-administered questionnaire surveys on Human papillomavirus knowledge, HPVV acceptability, and IMB construct toward HPV vaccination were performed at pre- and post-intervention. Results The baseline survey was completed by 3739 female university students from the intervention (n = 1936) and control groups (n = 1803) between February and April 2020. The average score of students on 11 HPV-related questions was 5.225 ± 2.739, and only 32.07% (1199/3739) of them showed a willingness to be vaccinated against HPV. After the intervention, the intervention group had a higher willingness to vaccinate themselves and encourage their friends to get the HPVV compared to the control group (40.39% vs 31.56%, 82.67 vs 73.18%, P < .001), and the difference in knowledge scores between the 2 groups was significant (7.917 ± 1.840 vs 5.590 ± 2.859, P < .001). In addition, 8 students in the intervention group self-reported receiving HPVV during the research period. Conclusions This IMB model-based intervention showed positive effects on the participants’ knowledge, motivation, and perceived objective skills toward HPV vaccination and has the potential to improve the vaccination among Chinese college women.
Collapse
Affiliation(s)
- Mingyu Si
- School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, 74496Jining Medical University, Jining, Shandong, China
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, 12519Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, 159428Xinjiang Medical University, Urumqi, China
| | - Li Ma
- School of Public Health, 36674Dalian Medical University, Dalian, China
| | - Jing Li
- West China School of Public Health, Sichuan University/West China Forth Hospital, 12530Sichuan University, Chengdu, China
| | - Shaokai Zhang
- 377327Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zefang Ren
- School of Public Health, 26469Sun Yat-sen University, Guangzhou, China
| | - Yuanli Liu
- School of Health Policy and Management, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
31
|
Xi X, Cao WL, Yao X, Chen J, Huang D, Yang T, Liu Z, Xie W, Xia Y, Zhong T. Rapid diagnosis of seven high-risk human papillomavirus subtypes by a novel loop-mediated isothermal amplification method. Mol Cell Probes 2021; 61:101787. [PMID: 34875349 DOI: 10.1016/j.mcp.2021.101787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 12/24/2022]
Abstract
Current human papillomavirus (HPV) detection methods require complex instruments, skilled staff and have a high cost. Therefore, novel testing approaches are needed which are easy to implement, highly sensitive, and low cost. Loop-mediated isothermal amplification (LAMP) is an isothermal amplification technique. In this study, according to the conditions in China, a novel LAMP method for detecting seven high-risk HPV subtypes (16, 18, 33, 39, 45, 52, and 58) was designed and evaluated. The DNA from plasmid and cervical specimens was extracted using Chelex 100 and measured by qPCR and LAMP assay. LAMP products were observed under ultraviolet light. HPV sequences were successfully amplified and a plateau time of 19-75 min was maintained. The concentration of positive reactions ranged between 20 copies/μL and 200000 copies/μL. Additionally, there was no cross-reactivity between HPV16, 18, 33, 39, 45, 52, 58, 31, 35, 45, 51, 56, 59, 66, or 68. For clinical samples, the LAMP assay had high sensitivity and specificity for HPV16, 18, 33, 39, 45, 52, and 58. However, 5% (72/1447) of the samples tested yielded false-positive results. In conclusion, the novel LAMP assay for HPV16, 18, 33, 39, 45, 52, and 58 has high sensitivity and specificity, a low cost, and is simple and rapid to perform. The LAMP assay can improve HPV detection in resource-limited settings, especially in primary care hospitals and rural areas.
Collapse
Affiliation(s)
- Xuxiang Xi
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Wen-Ling Cao
- Department of Clinical Laboratory, Guangzhou Institute of Dermatology, Guangzhou, Guangdong Province, China
| | - Xuebing Yao
- Department of Infectious Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Jie Chen
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Defa Huang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Tong Yang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Zhaoxia Liu
- Reproductive Medicine Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Wei Xie
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Yu Xia
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China
| | - Tianyu Zhong
- Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi Province, China.
| |
Collapse
|
32
|
Han X, Song G, Li Y, Dong Z, Yan X, Wang S, Tian H, Wu X, Li C, Huo Y. Prevalence and genotype distribution of human papillomavirus infection among women aged 30-65 years in Xi'an, China: a population-based study of 14,655 women. Hum Vaccin Immunother 2021; 17:5439-5446. [PMID: 34893010 PMCID: PMC8903934 DOI: 10.1080/21645515.2021.2007709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/14/2021] [Indexed: 12/16/2022] Open
Abstract
Cervical cancer is the fourth most common cancer among women worldwide in terms of both incidence and mortality. Persistent infection with high-risk human papillomavirus (HPV) has been identified as a cause of cervical intraepithelial neoplasia and invasive cervical cancer. The distribution of human papillomavirus genotypes varies regionally. To acquire baseline data on the population-based prevalence and genotype distribution of HPV infection, we investigated the molecular epidemiology of HPV infection among women in Xi'an, China. The study was conducted from September 2018 to December 2020. A total of 14,655 women aged 30-65 years were screened. The overall prevalence of HPV infection was 13.5% (95% confidence interval [CI]: 13.0-14.1%), with 10.4% of participants being positive for a single HPV type and 3.1% being positive for multiple HPV types. The prevalence of high-risk HPV (HR-HPV), low-risk HPV (LR-HPV) and mixed HPV infection was 10.1% (95% CI: 9.6-10.5%), 2.2% (95% CI: 2.0-2.4%), and 1.3% (95% CI: 1.1-1.5%), respectively. The five most frequently detected HR-HPV types were types 52 (2.6%), 16 (1.9%), 53 (1.8%), 58 (1.4%), and 51 (0.9%). The most frequently detected LR-HPV type was HPV-42 (1.1%). The prevalence and HPV genotype distribution varied by region and age. Age-specific HPV prevalence peaked in the over 60 years age group (18.8%), and Beilin District had the highest HPV prevalence (18.1%). The results of this first population-based study provide a reference for HPV-based cervical cancer screening and HPV vaccination programs in Xi'an.
Collapse
Affiliation(s)
- Xiaoxiao Han
- Department of Laboratory Medicine, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Guozhong Song
- Department of Laboratory Medicine, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Yufang Li
- Nuclear Medicine Diagnostic Center, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Zhaoqiang Dong
- Department of Laboratory Medicine, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Xianchun Yan
- Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Xi’an, China
| | - Suqing Wang
- Department of Science and Education, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Huizhen Tian
- Department of Laboratory Medicine, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Xiaohong Wu
- Department of Women’s Health, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Chen Li
- Department of Women’s Health, Xi’an Maternal and Child Health Care Hospital, Xi’an, China
| | - Yi Huo
- Department of Laboratory Medicine, 941 Hospital of Joint Logistics Support Force of PLA, Xining, China
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi’an, China
| |
Collapse
|
33
|
Niu J, Pan S, Wei Y, Hong Z, Gu L, Di W, Qiu L. Epidemiology and analysis of potential risk factors of high-risk human papillomavirus (HPV) in Shanghai China: A cross-sectional one-year study in non-vaccinated women. J Med Virol 2021; 94:761-770. [PMID: 34766625 DOI: 10.1002/jmv.27453] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 01/01/2023]
Abstract
Data regarding human papillomavirus (HPV) prevalence, its associated risk factors, and women's knowledge about this disease before the HPV vaccine was approved are limited in Shanghai, China. Therefore, we investigated these questions among females in Shanghai and aimed to provide comprehensive data to guide HPV vaccination and present the biopsychosocial risk factors that impact high-risk HPV infection, and evaluate the level of knowledge and awareness of this disease among women aged 21-65 years old. A total of 6619 (aged from 21 to 65) women from different communities volunteered to participate in the HPV screening and complete questionnaires from December 2016 to December 2017 in the Department of Obstetrics and Gynecology of nine hospitals in Shanghai. Data were analyzed using sample logistic regression to assess biopsychosocial risk factors that impact high-risk HPV infection and knowledge of HPV infection. A total of 632 (9.5%) cases were positive for high-risk HPV test, 22.6% of them were HPV 16/18 infection, 77.4% of them were non HPV 16/18 infection. 40 potential risk factors may be related to high-risk HPV infection, and there were 19 factors' p value < 0.1 from single factor logistic analysis. Finally, multivariable regression revealed education level, type of vaginitis, history of hyperlipidemias, family history of cancer, number of pregnancies, number of sex partners were independent risk factors for high-risk HPV infection (p < 0.05). When stratified by education level, women who finished graduate school had significantly greater knowledge of cervical cancer, cervical screening, and the relationship between HPV and cervical cancer than other groups (p < 0.05). The prevalence rate of high-risk HPV was a little lower than other regions in China and other countries, which may be related to regions, races, living habits, and economy. A less reported finding is that the history of vaginitis and the history of hyperlipidemias in our study were related to HPV infection. The majority of the participants had poor knowledge regarding cervical cancer, cervical screening, and the relationship between HPV and cervical cancer. Hence, these results should be served as a wake-up call for the government to increase knowledge and awareness via the media and doctors.
Collapse
Affiliation(s)
- Jiaxin Niu
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuting Pan
- Department of Clinical Center for Investigation, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yingting Wei
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zubei Hong
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liying Gu
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Di
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lihua Qiu
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Shanghai Key Laboratory of Gynecologic Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
34
|
Zhou F, Chen Y, Strickland AL, Chen H, Zhang X. Prevalence of genotype-specific human papillomavirus in cytology specimens and cervical biopsies, and its implication in cervical cancer risk stratification: a retrospective study of 10647 cases. J Cancer 2021; 12:7167-7176. [PMID: 34729118 PMCID: PMC8558667 DOI: 10.7150/jca.60601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022] Open
Abstract
Objective: This study aimed to describe the risk stratification of squamous cell carcinoma (SCC) and its precursor lesions based on HPV E6/E7 mRNA genotyping. Methods: 10647 hrHPV+ women (mean age 40.8 years), who had concurrent cytology and follow-up biopsy results available between September 2016 and May 2020, met the inclusion criteria and were selected for immediate risk analysis. Results: In this cohort, HPV-16 or 18/45+ women had significantly higher immediate risk of cervical cancer and precancer compared with other genotypes+ women. The relative immediate risk (RIR) of ASC-H+ was 2.0 (95% CI: 1.9-2.4) and SCC was 9.4 (95% CI: 5.5-15.6) for HPV-16 or 18/45+ women when compared with women positive for other 11 genotypes. Among follow-up biopsy cases, the RIR of CIN2+ was 2.7 (95% CI: 3.0-3.7) and SCC was 10.8 (95% CI: 7.2-17.4) for HPV-16 or 18/45+ women than women positive for other genotypes. Similarly, when compared with women positive for other genotypes, the RIR of CIN2+ was 2.9 (95% CI: 2.7-4.6) and SCC was 13.8 (95% CI: 3.0-66.2) for HPV-16 or 18/45+ women with ASC-US, and RIR of CIN2+ was 3.3 (95% CI: 3.1-4.6) and SCC was 22.3 (95% CI: 2.8-176.8) for HPV-16 or 18/45+ women with NILM. Conclusions: This study supports that hrHPV mRNA genotyping can be an effective risk stratification tool to identify individual at higher risk for cervical cancer or precancer, and provides important evidences for the future modifications for current China cervical cancer screening guidelines.
Collapse
Affiliation(s)
- Feng Zhou
- Department of Pathology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang Province, 310006, China
| | - Yuezhou Chen
- Reproductive Medicine Center, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, 528403, China
| | - Amanda Louise Strickland
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Hao Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xiaofei Zhang
- Department of Pathology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang Province, 310006, China
| |
Collapse
|
35
|
Yan X, Shen L, Xiao Y, Wang Q, Li F, Qian Y. Prevalence, characteristics, and distribution of HPV genotypes in women from Zhejiang Province, 2016-2020. Virol J 2021; 18:208. [PMID: 34670576 PMCID: PMC8527678 DOI: 10.1186/s12985-021-01676-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/12/2021] [Indexed: 02/02/2023] Open
Abstract
Objective To evaluate and understand the prevalence of HPV genotypes and characteristics of female populations in specific areas and the relationship with cervical lesions, which can effectively guide cervical cancer screening and formulate HPV vaccine prevention strategies. Methods A total of 77,443 women who visited gynecological clinics and underwent health examinations in the Second Affiliated Hospital of Zhejiang University School of Medicine during 2016–2020 were enrolled in this survey. Cervical samples were collected for HPV DNA genotyping and cervical cytology testing. Cervical biopsies were performed for patients with visible cervical abnormality or abnormal cytological results. Results The results showed the 5-year overall positive rate was 22.3%, of which the gynecology clinic group had significantly more positive results compared with the health examination group (P < 0.001). The five most common genotypes in Zhejiang Province were HPV 52, 58, CP8304, 16, and 51 (23.9%, 12.7%, 11.7%, 11.7% and 9.3%). HPV infection was age-specific, with the highest infection rate in the age group ≤ 20 compared to other age groups (P < 0.001). HPV infection was also season-specific, with the highest infection rate in spring or winter. The main HPV infection mode was single infection (P = 0.004), but patients ≤ 20 years old were more likely to develop multiple infections (51.0%). HPV 16, 52 and 58 were the main genotypes that caused cytological abnormalities and HPV16, 18, 56, 58 and 66 were independent risk factors for cervical lesions (OR = 2.352, 1.567, 2.000, 1.694, 1.889; all P < 0.05). Further analysis found HPV 16 and 18 were the main genotypes that cause cervical cancer histological abnormalities and were independent risk factors for cervical cancer (OR = 5.647, P < 0.001; OR = 3.495, P = 0.036). Conclusion This article analyzed the prevalence of distribution characteristics of HPV infection and revealed the corelation between HPV infection and cytological and histological abnormalities. Comprehensive results of this survey will help Zhejiang Province to formulate public health policies and provide evidence for future selection of specific HPV vaccines.
Collapse
Affiliation(s)
- Xiaotian Yan
- Department of Clinical Laboratory, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Lingwei Shen
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yufei Xiao
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qi Wang
- Department of Clinical Laboratory, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fugang Li
- Shanghai Upper Bio Tech Pharma Company Limited, Shanghai, China
| | - Yun Qian
- Department of Clinical Laboratory, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China.
| |
Collapse
|
36
|
Si M, Jiang Y, Su X, Wang W, Zhang X, Gu X, Ma L, Li J, Zhang S, Ren Z, Liu Y, Qiao Y. Willingness to Accept Human Papillomavirus Vaccination and its Influencing Factors Using Information-Motivation-Behavior Skills Model: A Cross-Sectional Study of Female College Freshmen in Mainland China. Cancer Control 2021; 28:10732748211032899. [PMID: 34634207 PMCID: PMC8516380 DOI: 10.1177/10732748211032899] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to assess the awareness and attitudes toward human papillomavirus (HPV) vaccination among female college freshmen and explore their willingness and associated factors to receive the HPV vaccine based on the information-motivation-behavior skills (IMB) model. METHODS From February 21 to April 30, 2020, a cross-sectional survey was conducted among female freshmen in seven colleges in mainland China. Socio-demographic characteristics, health-related awareness, knowledge of HPV, motivation, and behavioral skills toward HPV vaccination were assessed using questionnaires. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors of willingness to receive the HPV vaccine in the next 6 months. RESULTS Among the 3867 students invited to participate in this study, 102 (2.64%) reported having taken the HPV vaccine. Among the unvaccinated participants, 59.89% had previously heard of HPV, and 32.08% were willing to take the HPV vaccine in the next 6 months. Willingness to get the HPV vaccine was associated with sexual experience(s) (AOR = 1.96, 95% CI: 1.25-3.08), family or friends with cancer (AOR = 1.24, 95% CI: 1.04-1.48), having heard of HPV (AOR = 1.23, 95% CI: 1.03-1.47), and having actively searched for or having consulted on issues concerning HPV vaccine (AOR = 1.22, 95% CI: 1.02-1.45). In the dimensions of the IMB model, "perceived susceptibility" (AOR = 1.20, 95% CI: 1.09-1.31), "perceived severity" (AOR = 1.24, 95% CI: 1.11-1.39), "subjective norms" (AOR = 2.09, 95% CI: 1.75-2.49), and "self-efficacy" (AOR: 2.95, 95% CI: 2.44-3.58) were positively associated with HPV vaccination acceptance, while "perceived barriers" (AOR = .60, 95% CI: .52-.69) negatively affected intention to get HPV vaccination. CONCLUSION HPV vaccination rates and willingness to receive the HPV vaccine in the next 6 months were found to be poor among female college freshmen in mainland China. Having a positive attitude toward HPV vaccination, creating vaccine-friendly social norms, and removing related barriers are important measures to promote HPV immunization.
Collapse
Affiliation(s)
- Mingyu Si
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyou Su
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenjun Wang
- School of Nursing, 74496Jining Medical University, Jining, Shandong, China
| | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing Office for Cancer Prevention and Control, 12519Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaofen Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - Li Ma
- Public Health School, 36674Dalian Medical University, Dalian, China
| | - Jing Li
- West China School of Public Health, Sichuan University/West China Forth Hospital, 12530Sichuan University, Chengdu, China
| | - Shaokai Zhang
- 377327Henan Cancer Hospital, Affiliate Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zefang Ren
- School of Public Health, 26469Sun Yat-sen University, Guangzhou, China
| | - Yuanli Liu
- School of Health Policy and Management, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 12501Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
37
|
Yu H, Yi J, Dou YL, Chen Y, Kong LJ, Wu J. Prevalence and Genotype Distribution of Human Papillomavirus Among Healthy Females in Beijing, China, 2016-2019. Infect Drug Resist 2021; 14:4173-4182. [PMID: 34675562 PMCID: PMC8519791 DOI: 10.2147/idr.s332668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/30/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Human papillomavirus (HPV) infection, especially with high-risk HPV (HR-HPV) genotypes, is closely associated with cervical cancer. This study aimed to observe the epidemiological characteristics of HPV infection among healthy women in Beijing, China. MATERIALS AND METHODS Cervical specimens were collected from 29,436 healthy women, who underwent health check-ups in Peking Union Medical College Hospital between 2016 and 2019. A commercial kit was used for the detection of 15 HR-HPV and two low-risk HPV (LR-HPV) genotypes. RESULTS A total of 3586 (12.18%) participants tested positive for HPV, 3467 of which were infected with HR-HPVs. The most prevalent genotypes were HPV52, 58, 16, 51, and 56. Moreover, while infection with a single genotype (9.84%) was more prevalent, HPV16+52 was the most common combination in those infected with multiple HPVs. Furthermore, the highest infection rate among age groups was in women aged <25 years (20.92%). No significant difference in the prevalence was observed from 2016 to 2019. However, HPV incidence in Beijing was significantly different than that in all other areas in China, except for Zhengzhou (p < 0.05). CONCLUSION Our findings could serve as potential reference for better understanding of the epidemiological characteristics of HPV infection in Beijing.
Collapse
Affiliation(s)
- Hao Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
- Department of Laboratory Medicine, Beijing Hepingli Hospital, Beijing, People’s Republic of China
| | - Jie Yi
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
| | - Ya-ling Dou
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
| | - Yu Chen
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
| | - Ling-jun Kong
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
| | - Jie Wu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China
| |
Collapse
|
38
|
Wang H, Zhao J, Liu X, Yan W, Li G, Yuan Y. The Prevalence and Genotype Distribution of Human Papillomaviruses Among Men in Henan Province of China. Front Med (Lausanne) 2021; 8:676401. [PMID: 34616752 PMCID: PMC8488141 DOI: 10.3389/fmed.2021.676401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/26/2021] [Indexed: 12/13/2022] Open
Abstract
Background: This paper aimed to assess the prevalence of human papillomavirus (HPV) infection and the associations of sociodemographic and behavioral characteristics with HPV in unvaccinated men in Henan Province before the mass administration of the HPV vaccine through a baseline survey. Methods: Between June 2015 to June 2020, 3,690 men were tested for the HPV genotype at the Henan Provincial People's Hospital. The HPV genotype was detected by a polymerase chain reaction (PCR)-based hybridization gene chip assay. Results: The overall HPV infection rate was 29.97%; The most prevalent genotypes were HPV 6 (21.76%), 11 (12.68%), 16 (8.94%), 58 (5.37%), 18 (3.41%), 84 (3.25%), 61 (3.09%), and 81 (3.09%). Low-risk HPV (LR-HPV) infection (24.91%) and single infection (17.78%) were the most prevalent forms. Age-specific HPV distribution was presented as a bimodal curve; the youngest age group (≤ 25 years) had the highest HPV infection rate (36.03%), followed by the 36–40-year-old group (33.68%). Men with Junior high school or above were more likely to have Pure-LR HPV infection. Unmarried status and smoking increased single and LR-HPV infection. Multiple lifetime sex partners and not using a condom were more likely to cause LR-HPV infection. Conclusions: The data on the prevalence and HPV infection type distribution in men in Henan Province could serve as a valuable reference to guide nationwide screening. We provide a time-based estimate of the maximum impact of the HPV vaccine and critical reference measurements important for assessing the clinical benefits of HPV vaccination and the increase in non-vaccine HPV types.
Collapse
Affiliation(s)
- Huiling Wang
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| | - Jing Zhao
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| | - Xiaoli Liu
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| | - Wenjuan Yan
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| | - Gang Li
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| | - Youhua Yuan
- Department of Clinical Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.,People's Hospital of Henan University, Kaifeng, China
| |
Collapse
|
39
|
Genetic characteristics of human papillomavirus type 16, 18, 52 and 58 in southern China. Genomics 2021; 113:3895-3906. [PMID: 34555497 DOI: 10.1016/j.ygeno.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/15/2021] [Accepted: 09/09/2021] [Indexed: 11/21/2022]
Abstract
Persistent infections of high-risk human papillomaviruses (HPVs) are the leading cause of cervical cancers. We collected cervical exfoliated cell samples from females in Changsha city, Hunan Province and obtained 338 viral genomes of four major HPV types, including HPV 16 (n = 82), 18 (n = 35), 52 (n = 121) and 58 (n = 100). The lineage/sublineage distribution of the four HPVs confirmed previous epidemiological reports, with the predominant prevailing sublineage as A4 (50%), A1 (37%) and A3 (13%) for HPV16, A1 (83%) for HPV18, B2 (86%) for HPV52 and A1 (65%), A3 (19%) and A2 (12%) for HPV58. We also identified two potentially novel HPV18 sublineages, i.e. A6 and A7. Virus mutation analysis further revealed the presence of HPV16 and HPV58 sublineages associated with potentially high oncogenicity. These findings expanded our knowledge of the HPV genetic diversity in China, providing valuable evidence to facilitate HPV DNA screening, vaccine effectiveness evaluation and control strategy development.
Collapse
|
40
|
Wang L, Yu C, Ni X, Wang F, Wen C, Jin M, Chen J, Zhang K, Wang J. Prevalence characteristics of human papillomavirus (HPV) infection among women receiving physical examinations in the Shangcheng District, Hangzhou city, China. Sci Rep 2021; 11:16538. [PMID: 34400720 PMCID: PMC8368293 DOI: 10.1038/s41598-021-96131-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 08/02/2021] [Indexed: 11/23/2022] Open
Abstract
This paper aimed to investigate the characteristics of female HPV infection in the Shangcheng District, Hangzhou city, China. The retrospective study was designed to analyze the HPV prevalence rate of 22,382 women receiving physical examinations from 2016 to 2020 in the Shangcheng District of Hangzhou city in China. A commercial kit was designed to detect the HPV genotypes. Trends were examined for age-specific groups (≤ 30 years, 31–44 years, 45–54 years, 55–64 years, ≥ 65 years). A receiver operating characteristic (ROC) analysis was used to assess the correlation of age classification in high risk HPV (HR-HPV) infection. 22.41% (5015/22,382) of samples were HPV positive, 91.28% (4578/5015) of HPV positive women were infected by HR-HPV. The most prevalent HR-HPV genotypes were 16, 52, 18, 58, 56, and 51. The trend of HPV prevalence showed the significant differences in age-specific groups (χ2 = 164.70, P < 0.001). Moreover, the areas under ROC curve (AUC) was 0.712 in 55–64 years group which showed a strong contribution of age classification for HR-HPV infection. This study provided baseline data on the prevalence characteristics of HPV infection and the critical age group of HR-HPV prevalence rate was 55–64 y among the samples receiving physical examinations.
Collapse
Affiliation(s)
- Lu Wang
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Chunfeng Yu
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Xiaoling Ni
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Fang Wang
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Caihe Wen
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Mei Jin
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Juanjuan Chen
- Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China
| | - Kunming Zhang
- Department of Clinical Laboratory, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiahao Wang
- Department of Radiation Oncology, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| |
Collapse
|
41
|
Wang X, Wu S, Li Y. Risks for cervical abnormalities in women with non-16/18 high-risk human papillomavirus infections in south Shanghai, China. J Med Virol 2021; 93:6355-6361. [PMID: 34232523 DOI: 10.1002/jmv.27185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/01/2021] [Accepted: 07/05/2021] [Indexed: 11/09/2022]
Abstract
The study was aimed to analyze the prevalence characteristics of non-16/18 high-risk human papillomaviruses (HR-HPV) and the related risks for cervical abnormalities in south Shanghai. A total of 2291 HPV women who had been referred for a colposcopy due to HPV infection from @@@@@2016.12 to 2019.6 were enrolled. Combined with liquid-based thin-layer cell test (TCT) and pathological results of cervical biopsy, the infection spectrum and pathogenic risk of non-16/18 HR-HPV in local population were investigated. The results showed that the single HR-HPV infection rate was significantly higher than that of multiple infection, and the five most frequently detected types were HPV16, HPV52, HPV18, HPV53, HPV58 in the group. The total proportion of non-16/18 HR-HPV infection was 68.22%, more than twice of HPV16/18. In cases with high-grade cervical intraepithelial lesions (HSIL) or cervical cancer, non-16/18 HR-HPV infections account for 50.84% (single infection: 28.57%, multiple infection: 22.27%). The risk of cervical abnormalities caused by single HPV infection was ranked as HPV16 > HPV52 > HPV18 = HPV58 > HPV51 > HPV53 = HPV56 > others. Notably, among non-16/18 HR-HPV infected patients with HSIL/cancer lesions, the omission diagnostic rate of TCT was 62.81%. The infection rate of non-16/18 HR-HPV in whole study population was much higher than that of 16/18 type, and the infection rate of the former was also slightly higher in patients with HSIL and cancer. Due to the high omission diagnostic rate of TCT, we suggest patients with persistent non-16/18 HPV infection should undergo colposcopy biopsy to reduce missed detection of HSIL and cancers.
Collapse
Affiliation(s)
- Xiaoyun Wang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sufang Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanli Li
- Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
42
|
Guo M, Xu J, Du J. Trends in cervical cancer mortality in China from 1989 to 2018: an age-period-cohort study and Joinpoint analysis. BMC Public Health 2021; 21:1329. [PMID: 34229639 PMCID: PMC8259057 DOI: 10.1186/s12889-021-11401-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 06/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background Worldwide, cervical cancer is the second-most-common malignancy of the female reproductive system. Due to its large population, China accounted for 11.9% of cervical cancer deaths, and 12.3% of global cervical cancer DALYs in 2017. In 2009, China launched a nationwide screening program, yet mortality from cervical cancer has shown an upward trend in recent years. The aim of this study was to explore factors affecting cervical cancer mortality rates in China, and contribute to their future reduction. Methods In this descriptive study, a Joinpoint regression analysis and age-period-cohort (APC) model based on the intrinsic estimator (IE) algorithm were utilized. Data from the period 1989–2018 were extracted from the International Agency for Research on Cancer (IARC) Database of WHO (1989–2000) and China Health Statistical Yearbook database (2002–2018). Results Our study found mortality from cervical cancer to have initially declined, but increase thereafter over the entire observation period in both rural and urban China. The influence of age, period and cohort effect on the mortality rate had statistical significance. The effect of age increased with years, becoming a contributing factor in women aged over 45 years countrywide. Conversely, the cohort effect became a protective factor for women born after 1938 in urban areas, and for women born after 1958 in rural areas. The period effect was relatively less impactful. Conclusions The study indicates that organized cervical screening projects facilitated the identification of potential patients, or patients with comorbidities. Correspondingly, mortality was found to increase with incidence, particularly among elderly women, indicating that newly diagnosed patients were at an advanced stage of cervical cancer, or were not receiving appropriate treatment. Therefore, the coverage of cervical cancer screening should be improved, and women’s health awareness promoted. Early diagnosis and treatment is critical to reduce the disease burden and improve outcomes.
Collapse
Affiliation(s)
- Menghan Guo
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430030, Hubei Province, China.,Hubei Provincial Research Center for Health Technology Assessment, Wuhan, 430030, Hubei Province, China
| | - Juan Xu
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430030, Hubei Province, China. .,Hubei Provincial Research Center for Health Technology Assessment, Wuhan, 430030, Hubei Province, China. .,Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
| | - Jiayue Du
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430030, Hubei Province, China.,Hubei Provincial Research Center for Health Technology Assessment, Wuhan, 430030, Hubei Province, China
| |
Collapse
|
43
|
Wei L, Xie X, Liu J, Qiao Y, Zhao F, Wu T, Zhang J, Ma D, Kong B, Chen W, Zhao C, Zhao Y, Li J, Li M, Xia N. Elimination of Cervical Cancer: Challenges Promoting the HPV Vaccine in China. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021; 19:51. [PMID: 34222614 PMCID: PMC8236217 DOI: 10.1007/s40944-021-00536-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective Cervical cancers present major threats to women's health in China. Eliminating cervical cancer in China is a huge challenge, with application of the HPV vaccine, which is an important part. Methods There are currently four HPV vaccines available in China: E-coli bv-HPV (Wantai, China), bv-HPV, qv-HPV (GSK, UK), and 9v-HPV (MSD, USA). To observe the immunogenicity, efficacy, and safety of these four vaccines in China, we formed the "Chinese Expert Consensus on the Clinical Application of HPV Vaccine." Results At 7 months after vaccination, all vaccinated subjects had the same immunogenic response to either HPV16 or HPV18, ranging from 96 to 100%, and antibody production in girls aged 9-14 years was 2-3 times higher than that in adult women. Efficacy of the four vaccines against CIN2 + ranged from 87.3% to 100%, with prevention of HPV-associated infection reaching 96% ~ 97% at 12 months. Clinical trials showed bv-HPV and qv-HPV vaccine were also safe in women aged 18-45 years. Clinical trials of the 9v-HPV vaccine are underway. HPV vaccination is currently voluntary and self-paid in China. The "Chinese Expert Consensus on the Clinical Application of HPV Vaccine" will work to promote the application of HPV vaccine in China. Conclusions In clinical studies, the available HPV vaccines showed excellent efficacy, safety, and immunogenicity in Chinese women. We will continue strengthening screening and encouraging HPV vaccination.
Collapse
Affiliation(s)
- Lihui Wei
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Xing Xie
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Jihong Liu
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Youlin Qiao
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Fanghui Zhao
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Ting Wu
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Jun Zhang
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Ding Ma
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Beihua Kong
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Wen Chen
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Chao Zhao
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Yun Zhao
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Jingran Li
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Mingzhu Li
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| | - Ningshao Xia
- Deparment of Gynecology and Obstetrics, Peking University People’s Hospital, No.11# Xizhimen South St. Xicheng District, Beijing, 100044 China
| |
Collapse
|
44
|
Huang R, Wang Z, Yuan T, Nadarzynski T, Qian HZ, Li P, Meng X, Wang G, Zhou Y, Luo D, Wang Y, Cai Y, Zou H. Using protection motivation theory to explain the intention to initiate human papillomavirus vaccination among men who have sex with men in China. Tumour Virus Res 2021; 12:200222. [PMID: 34175495 PMCID: PMC8261654 DOI: 10.1016/j.tvr.2021.200222] [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: 03/10/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) infection and related diseases are common among men who have sex with men (MSM). The most effective prevention is HPV vaccination. In China, however, men are not included in the HPV vaccination plan. We investigated the intention to initiate HPV vaccination and associated factors among MSM in China. Methods We surveyed 563 unvaccinated MSM aged 18 or older from six cities in China. Participants completed an electronic questionnaire about demographics, knowledge of and attitude towards HPV and HPV vaccine, intention to initiate HPV vaccination, willingness to recommend HPV vaccine to peers, feeling about government policy about HPV vaccination. We used the structural equation modeling (SEM) to analyze factors associated with HPV vaccine intention. Results The knowledge of HPV and HPV vaccine among participants was low. The mean score of knowledge about HPV and HPV vaccine was only 1.59 (range 0–11). The intention to initiate HPV vaccination within 6 months among participants was moderate (43.3% in total, 18.1% for ‘very high' and 25.2% for ‘above average'). Low level of knowledge and intention to initiate HPV vaccination among MSM in China. Most variables of The Protection Motivation Theory were associated factors. Tailored intervention should be applied among MSM in China. Promotion of publicity and subsidization should be also considered.
Collapse
Affiliation(s)
- Ruonan Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Zhenyu Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China
| | - Tom Nadarzynski
- The University of Westminster, 115 New Cavendish St, Fitzrovia, London, W1W 6UW, United Kingdom
| | - Han-Zhu Qian
- Yale School of Public Health, New Haven, CT, USA
| | - Peiyang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Xiaojun Meng
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, PR China
| | - Guanghui Wang
- Qingdao Qingtong AIDS Prevention Volunteer Service Center, Qingdao, PR China
| | - Yepeng Zhou
- Foshan Friends Care Center for AIDS/HIV Control, Foshan, PR China
| | - Danyang Luo
- Zhitong LGBT Service Center, Guangzhou, PR China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, PR China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Kirby Institute, University of New South Wales, Sydney, Australia.
| |
Collapse
|
45
|
Xiang J, Han L, Fan Y, Feng B, Wu H, Hu C, Qi M, Wang H, Liu Q, Liu Y. Prevalence and Genotype Distribution of Human Papillomavirus Among Attendees at a Sexually Transmitted Diseases Clinic in Urban Tianjin, China. Int J Gen Med 2021; 14:1983-1990. [PMID: 34045890 PMCID: PMC8144902 DOI: 10.2147/ijgm.s308215] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/21/2021] [Indexed: 01/02/2023] Open
Abstract
Background Human papillomavirus (HPV) is linked to various cancers in males and females. The prevalence and genotype distribution of HPV vary depending on geographical region and the immunity provided by vaccines. Investigation of HPV epidemiology is of great meaning for the development of prevention programs. Methods From January 2017 to September 2019, using PCR-reverse dot blot hybridisation, we determined the HPV subtypes in 2801 patients 17-89 years old at the sexually transmitted diseases (STD) clinic of Tianjin Medical University General Hospital. Results The HPV infection rate was 50.79% in males and 50.64% in females. The most common HPV genotype in males and females was HPV6 (30.15% and 30.43%), followed by HPV16 (18.76% and 20.65%) and HPV11 (14.61% and 15.67%). Infection with a single HPV subtype predominated in both males and females, and the rate in males was higher than in females. By contrast, the rate of high-risk HPV (hrHPV) and low-risk HPV (lrHPV) mixed infection in females was higher than in males. Most HPV-positive patients were 20-39 years of age. The prevalence of infection with only hrHPV differed among the age groups; the peak age was 50 to 59 years. Conclusion The HPV prevalence was higher among the STD clinic outpatients than the general population. Therefore, a large-scale survey of high-risk populations is needed. It is anticipated that HPV vaccines, regular education and physical examinations may have a significant impact on the prevention of HPV-related diseases in high-risk groups.
Collapse
Affiliation(s)
- Junqiu Xiang
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Long Han
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Yanfei Fan
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Bin Feng
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Haoqing Wu
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Chunmin Hu
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Manli Qi
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Huiping Wang
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Quanzhong Liu
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| | - Yuanjun Liu
- Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China
| |
Collapse
|
46
|
Chen L, Dong Y, Li J, Zhao J, Wang D, Xu L, Wu Y, Liu H, Lu J, Yao Z, Li X. The genomic distribution map of human papillomavirus in Western China. Epidemiol Infect 2021; 149:e135. [PMID: 34001298 PMCID: PMC8193771 DOI: 10.1017/s0950268821001175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 01/09/2023] Open
Abstract
Human papillomavirus (HPV) has been confirmed as the causative agent for cervical cancer. In this study, a total of 301 880 women were recruited from four different regions of Western China, with 301 880 exfoliated cervical cell samples collected from women for DNA isolation and purification. The HPV genotype was tested by polymerase chain reaction. The overall HPV prevalence rate, high-risk (HR) HPV infection rate, low-risk (LR) HPV infection rate and mixed HPV infection rate was 18.24%, 79.14%, 12.56% and 8.30%, respectively. The four most common HR HPV subtypes were HPV-52, 16, 58 and 53, which accounted for 20.49%, 19.93%, 14.54% and 10.01%, respectively. In LR HPV genotype, HPV-6 ranked the highest (28.17%), followed by HPV-81 (9.09%) and HPV-11 (3.78%). HPV genotype subgroup analysis also showed that single-type infection was the most common (77.26%) among HPV-positive individuals. Among multi-infection genotypes, double infection was the most common with frequencies of 76.04%. The overall prevalence of HPV is high in Western China, whose distribution demonstrates different patterns across different ages and regions. Viral genotypes HPV 53, 6 were frequently detected in this population, which is worth of significant clinical attention.
Collapse
Affiliation(s)
- Ling Chen
- The Center of Experimental Teaching Management, Chongqing Medical University, Chongqing401331, China
| | - Yan Dong
- Department of Microbiology and Immunology, Kunming Medical University, Kunming650031, China
| | - Jiao Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, China
| | - Jinqiu Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing400016, China
| | - Dan Wang
- Department of Clinical Laboratory, People's Hospital of Rongchang District, Rongchang, Chongqing402460, China
| | - Li Xu
- Department of Clinical Laboratory, the First Affiliated Hospital of AMU, Chongqing400038, China
| | - Yue Wu
- Oncology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing400016, China
| | - Huandong Liu
- Department of Neurosurgery, People's Hospital of Tibet Autonomous Region, Lhasa850000, China
| | - Jungao Lu
- Department of Clinical Laboratory, The Third Affiliated Hospital of Guizhou Medical University, Duyun558000, China
| | - Zuoyi Yao
- Department of General Surgery, The Chengdu Fifth People's Hospital, Chengdu611130, China
| | - Xiaosong Li
- Clinical Molecular Medicine Testing Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing400016, China
| |
Collapse
|
47
|
Wu J, Xiao F, Zheng Y, Lin Y, Wang HL. Worldwide trend in human papillomavirus-attributable cancer incidence rates between 1990 and 2012 and Bayesian projection to 2030. Cancer 2021; 127:3172-3182. [PMID: 33974715 DOI: 10.1002/cncr.33628] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/23/2021] [Accepted: 04/09/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a paucity of global comparative trend analyses of all human papillomavirus (HPV)-attributable cancers. In addition, most analyses by international sources only describe past trends; few studies have projected the future trend of HPV-attributable cancers. METHODS Data were used from the Cancer Incidence in Five Continents (CI5plus) database that contains annual incidence by cancer site, age, and sex, as well as corresponding populations. Age-standardized HPV-attributable cancer incidence rates were calculated and plotted from 1990 through 2012. A Bayesian age-period-cohort model was used to project the HPV-attributable cancer incidence rates of each country up to 2030. RESULTS A significant but small decreasing trend worldwide in the HPV-attributable cancer incidence rate was observed with an average annual percent change (AAPC) of -0.3 (95% CI, -0.6 to -0.1). Notably, Uganda had a consistently increasing trend of HPV-attributable cancer incidence rate, with an AAPC of 1.7 (95% CI, 0.6-2.9). U-shaped trends were observed in some high-income countries because of a recent increase in oral cavity and oropharyngeal cancers. Most countries experience a decreasing or stable trend in HPV-attributable cancers incidence rates between 1990 and 2030. However, Japan, the United Kingdom, the Netherlands, Italy, Costa Rica, and Uganda will have an increasing trend during the projection period. CONCLUSIONS Analyses revealed favorable downward trends in HPV-attributable cancer incidence rates in most of the included countries. However, the persistently increasing trend in HPV-attributable cancer incidence rates in Uganda and the recent increase in oral cavity and oropharyngeal cancer incidence rates in some high-income countries may present a new challenge for global HPV-attributable cancer prevention. LAY SUMMARY Analyses revealed favorable downward trends in human papillomavirus (HPV)-attributable cancer incidence rates in most of the included countries. However, the persistently increasing trend in HPV-attributable cancer incidence rates in Uganda and the recent increase in oral cavity and oropharyngeal cancer incidence rates in some high-income countries may present a new challenge for global HPV-attributable cancer prevention.
Collapse
Affiliation(s)
- Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fenqiang Xiao
- Department of Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hong-Liang Wang
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
48
|
Dong B, Zou H, Mao X, Su Y, Gao H, Xie F, Lv Y, Chen Y, Kang Y, Xue H, Pan D, Sun P. Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study. Ther Adv Med Oncol 2021; 13:17588359211010939. [PMID: 33995595 PMCID: PMC8107662 DOI: 10.1177/17588359211010939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 03/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.
Collapse
Affiliation(s)
- Binhua Dong
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, P.R. China
| | - Xiaodan Mao
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, Fujian, P.R. China
| | - Hangjing Gao
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Fang Xie
- Department of Obstetrics and Gynecology, Mindong Hospital of Fujian Medical University, Fuan, Fujian, P.R. China
| | - Yuchun Lv
- Department of Obstetrics and Gynecology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, P.R. China
| | - Yaojia Chen
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Yafang Kang
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Huifeng Xue
- Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Diling Pan
- Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China
| | - Pengming Sun
- Laboratory of Gynecologic Oncology, Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou, Fujian 350001, P.R. China
| |
Collapse
|
49
|
Luo LP, He P, Liu QT, Jiang YH, Zhang YN, Li QZ, Li Q, Li ST, Yang F, Ling H, Dai XG, Li ZY, Chen HL. Prevalence and genotype distribution of HPV infection among 214,715 women from Southern China, 2012-2018: baseline measures prior to mass HPV vaccination. BMC Infect Dis 2021; 21:328. [PMID: 33827456 PMCID: PMC8028771 DOI: 10.1186/s12879-021-06019-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 03/28/2021] [Indexed: 12/12/2022] Open
Abstract
Background The epidemiology on the human papillomavirus (HPV) among females in Southern China is not well-established. Baseline data on the prevalence of HPV infection in China prior to mass prophylactic HPV vaccination would be useful. Thus, this study aims to determine the type-specific HPV prevalence and distribution among females from Southern China prior to mass HPV vaccination. Methods A retrospective cross-sectional study employing 214,715 women attending ChenZhou NO.1 People’s Hospital for cervical screening during 2012–2018 was conducted prior to widespread HPV vaccination. HPV genotype was detected using nucleic acid molecular diversion hybridization tests. The overall prevalence, age-specific prevalence, type distribution, and annual trend were analyzed. Results The overall HPV prevalence was 18.71% (95% confidence interval [CI], 18.55–18.88%) among Southern China females. During 2012–2018, the prevalence of HPV infection showed a downward tendency, from 21.63% (95% CI, 21.07–22.20%) in 2012 to 18.75% (95% CI, 18.35–19.16%) in 2018. Age-specific HPV distribution displayed a peak at young women aged less than 21 years (33.11, 95% CI, 31.13–35.15%), 20.07% (95% CI, 19.70–20.44%) among women aged 21–30 years, 17.29% (95% CI, 17.01–17.57%) among women aged 31–40 years, 17.23% (95% CI, 16.95–17.51%) among women aged 41–50 years, 21.65% (95% CI, 21.11–22.20%) among women aged 51–60 years, and 25.95% (95% CI, 24.86–27.07%) among women aged over 60 years. Of the 21 subtypes identified, the top three prevalent high-risk HPV (HR-HPV) genotypes were HPV52 (5.12%; 95% CI, 21.11–22.20%), − 16 (2.96%; 95% CI, 2.89–3.03%), and − 58 (2.51%; 95% CI, 2.44–2.58%); the predominant low-risk HPV (LR-HPV) genotypes were HPV81 (1.86%; 95%CI, 1.80–1.92%) and − 6 (0.69%; 95% CI, 0.66–0.73%) respectively. Incidence of HR-HPV only, LR-HPV only and mixed LR- and HR-HPV were 15.17, 2.07 and 1.47% respectively. Besides, single HPV infection accounted for 77.30% of all positive cases in this study. Conclusions This study highlights 1) a high prevalence of HPV infection among females with a decreasing tendency towards 2012–2018, especially for young women under the age of 21 prior to mass HPV vaccination; 2) HPV52, − 16 and − 58 were the predominant HPV genotypes, suggesting potential use of HPV vaccine covering these HPV genotypes in Southern China.
Collapse
Affiliation(s)
- Li-Pei Luo
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Ping He
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Qiao-Tu Liu
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Yang-Hua Jiang
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Yang-Nan Zhang
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Qing-Zhao Li
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Qiu Li
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Sheng-Tao Li
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Fan Yang
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Hua Ling
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Xin-Gui Dai
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China
| | - Zhong-Yu Li
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China. .,Institute of Pathogenic Biology, Hengyang Medical College, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, 421001, P.R. China.
| | - Hong-Liang Chen
- The First School of Clinical Medicine, Southern Medical University, Chenzhou NO.1 People's Hospital, Chenzhou, 423000, P.R. China. .,Institute of Pathogenic Biology, Hengyang Medical College, Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, 421001, P.R. China.
| |
Collapse
|
50
|
Weng J, Sheng N, Wang R, Liang S, Wang C, Bai X, Zhou G, Zou B, Song Q. Multiplex Visualized Closed-Tube PCR with Hamming Distance 2 Code for 15 HPV Subtype Typing. Anal Chem 2021; 93:5529-5536. [PMID: 33752323 DOI: 10.1021/acs.analchem.1c00035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cervical cancer is the fourth leading cause of death in women, especially in developing countries. Specific and economic methodologies for HPV typing are crucial in cancer diagnosis and further disease control. However, routine assays based on real-time polymerase chain reaction (qPCR) or DNA-chip hybridization are either incapable of offering detailed subtype information or involve tedious open-tube operations with the risk of cross-contamination from PCR amplicons. Herein, we proposed a multiplex visualized closed-tube PCR (Multi-Vision) for HPV typing. Using gold nanoparticle probes (AuNPs) as a color change indicator combined with a Hamming distance 2 coding scheme, 13 high-risk HPVs and two subtypes associated with high-incidence benign lesions were successfully typed by performing six closed-tube PCRs. The assay demonstrates high specificity with no cross-reaction among different subtypes under several artificial sample concentrations (from 100 to 103 copies per reaction) and enables highly sensitive detection of as low as 0.5 copies/μL. Further, 105 clinical samples were successfully analyzed using our method with a high concordance rate of 99.05% (104/105) compared to a HPV typing kit. The inconsistent sample was confirmed by sequencing to be consistent with the typing results determined by our method, indicating that Multi-Vision could be a useful tool for HPV detection, especially in resource-limited regions.
Collapse
Affiliation(s)
- Jixue Weng
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Nan Sheng
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Runyuan Wang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Shuo Liang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Chen Wang
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Xue Bai
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| | - Guohua Zhou
- Department of Clinical Pharmacy, Jinling Hospital, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing 210002, China.,School of Pharmacy, Southern Medical University, Guangzhou 510515, China
| | - Bingjie Zou
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China.,Department of Clinical Pharmacy, Jinling Hospital, State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing 210002, China
| | - Qinxin Song
- Key Laboratory of Drug Quality Control and Pharmacovigilance, Ministry of Education, School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China
| |
Collapse
|