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Andujar M, Roura E, Torres A, Vega B, Pavcovich M, Sanchez MA, Lubrano A, Trujillo JL, Almeida L, Santana M, Hurtado R, Arencibia O, Benito V, Medina N, Carballo S, Camacho MDC, Ruiz Del Pozo A, Quesada A, Salido E, de Sanjosé S, Bruni L. Prevalence and genotype distribution of cervical human papilomavirus infection in the pre-vaccination era: a population-based study in the Canary Islands. BMJ Open 2020; 10:e037402. [PMID: 32973061 PMCID: PMC7517562 DOI: 10.1136/bmjopen-2020-037402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE National Spanish studies show that prevalence of cervical human papillomavirus (HPV) infection in the female population is increasingly frequent, with an overall estimate of 14% in women aged 18-65 years. The objective of this study is to know the prevalence and distribution of HPV types in the female population of the Canary Islands prior to the introduction of HPV vaccines and to investigate the associated clinical and sociodemographic factors. METHODS Based on the Primary Health Care database, a sample of adult women (aged 18-65 years) of Gran Canaria (GC) and Tenerife (TF) stratified into nine age groups was carried out between 2002 and 2007. Women were contacted by postal letter and telephone call and were visited in their primary care centre. A clinical-epidemiological survey was completed and cervical samples were taken for cytological study and HPV detection. HPV prevalence and its 95% CI were estimated, and multivariate analyses were performed using logistic regression to identify factors associated with the infection. RESULTS 6010 women participated in the study, 3847 from GC and 2163 from TF. The overall prevalence of HPV infection was 13.6% (CI 12.8%-14.5%) and 11.1% (CI 10.3%-11.9%) for high-risk types. The most frequent HPV type was 16 followed by types 51, 53, 31, 42 and 59. HPV types included in the nonavalent vaccine were detected in 54.1% of infected women. Factors associated with an increased risk of infection were: young ages (18-29 years), the number of sexual partners throughout life, not being married, being a smoker, and having had previous cervical lesions or genital warts. CONCLUSIONS It is confirmed that prevalence of HPV infection in the female population of the Canary Islands is high, but similar to that of Spain, HPV 16 being the most frequent genotype. The determinants of infection are consistent with those of other populations.
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Affiliation(s)
- Miguel Andujar
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Esther Roura
- Unit of Infections and Cancer-Information and Interventions (UNIC-I&I)-Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alejandra Torres
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Begoña Vega
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Marta Pavcovich
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Miguel Angel Sanchez
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Amina Lubrano
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Jose Luis Trujillo
- Department of Obstetrics and Gynecology, Hospital Universitario de Canarias, La Laguna, Spain
| | - Lucia Almeida
- Department of Obstetrics and Gynecology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Milagros Santana
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Rosaura Hurtado
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Octavio Arencibia
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Virginia Benito
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Norberto Medina
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Sonia Carballo
- Department of Obstetrics and Gynecology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Maria Del Carmen Camacho
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Arancha Ruiz Del Pozo
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Alfoso Quesada
- Department of Obstetrics and Gynecology, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Eduardo Salido
- Department of Pathology, Hospital Universitario de Canarias, La Laguna, Spain
| | - Silvia de Sanjosé
- Reproductive Health Global Programme, PATH, Seattle, Washington, USA
- Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Laia Bruni
- Unit of Infections and Cancer-Information and Interventions (UNIC-I&I)-Cancer Epidemiology Research Program (CERP)-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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2
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Álvarez-Paredes L, Santibañez M, Galiana A, Rodríguez Díaz JC, Parás-Bravo P, Andrada-Becerra ME, Ruiz García MM, Rodríguez-Ingelmo JM, Portilla-Sogorb J, Paz-Zulueta M. Association of Human Papillomavirus Genotype 16 Viral Variant and Viral Load with Cervical High-grade Intraepithelial Lesions. Cancer Prev Res (Phila) 2019; 12:547-556. [PMID: 31208965 DOI: 10.1158/1940-6207.capr-18-0397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/15/2019] [Accepted: 06/11/2019] [Indexed: 11/16/2022]
Abstract
Human papillomavirus genotype 16 (HPV16) is by far the genotype most strongly associated with cervical cancer; viral variant and/or viral load of HPV16 could modulate this association. The objective was to determine the association between the viral variant and viral load of HPV16 and the presence of cervical high-grade lesions. This cross-sectional study included all women in whom HPV infection was found by cervical smear during routine gynecologic health checks. Women with single or multiple HPV16 infections (n = 176) were selected for viral variant and viral load analysis. Smear results were classified using the Bethesda system. HPV types were classified according to the International Agency for Research on Cancer. Odds ratios (OR) with their 95% confidence intervals (CI) were estimated by logistic regression, adjusted for age, immigrant status, and coinfection with other high-risk genotypes. No statistically significant associations were found regarding the detected viral variants. A viral load above the median (>1,367.79 copies/cell) was associated with a significant risk of high-grade epithelial lesion or carcinoma, after adjusting for age, immigrant status, coinfections, and viral variant: (adjusted OR 7.89; 95% CI: 2.75-22.68). This relationship showed a statistically significant dose-response pattern after categorizing by viral load tertiles: adjusted OR for a viral load greater than the third tertile was 17.23 (95% CI: 4.20-70.65), with adjusted linear P trend = 0.001. In patients infected with HPV16, viral load is associated with high-grade intraepithelial lesions or cervical carcinoma. This could be useful as prognostic biomarker of neoplastic progression and as screening for cervical cancer.
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Affiliation(s)
| | - Miguel Santibañez
- Department of Nursing, Nursing Research Group-IDIVAL, University of Cantabria, Cantabria, Spain
| | - Antonio Galiana
- Department of Microbiology, University General Hospital of Elche, Alicante, Spain
| | | | - Paula Parás-Bravo
- Department of Nursing, Nursing Research Group-IDIVAL, University of Cantabria, Cantabria, Spain
| | | | | | | | | | - María Paz-Zulueta
- Department of Nursing, University of Cantabria, Cantabria, Spain. IDIVAL, GI Derecho Sanitario y Bioetica, GRIDES, Cantabria, Spain.
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Purriños-Hermida MJ, Santiago-Pérez MI, Treviño M, Dopazo R, Cañizares A, Bonacho I, Trigo M, Fernández ME, Cid A, Gómez D, Ordóñez P, Coira A, Armada MJ, Porto M, Perez S, Malvar-Pintos A. Direct, indirect and total effectiveness of bivalent HPV vaccine in women in Galicia, Spain. PLoS One 2018; 13:e0201653. [PMID: 30075010 PMCID: PMC6075752 DOI: 10.1371/journal.pone.0201653] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/19/2018] [Indexed: 01/08/2023] Open
Abstract
Bivalent human papillomavirus (HPV) vaccine was incorporated into the childhood vaccination calendar in Galicia, Spain in 2008. The objectives of this study were to estimate direct, indirect and total effectiveness of HPV vaccine and to identify sexual habits changes in the post-vaccination period in Galicia, Spain.Endocervical scrapings of 745 women attending 7 Health Areas of the Galician Public Health Service were collected in the post-vaccination period, from 2014-2017. Two groups were studied: women born between 1989 and 1993 (n = 397) and women born in 1994 or later (n = 348). Twelve high-risk human papillomavirus (HR-HPV) genotypes were detected by Cobas® 4800 HPV test (Roche Diagnostics, Mannheim, Germany). The Linear Array® HPV Genotyping Test (Roche Diagnostics) was used for HR-HPV genotype detection other than HPV 16/18. Information about sexual habits was collected by a self-filled questionnaire. Post-vaccination data were compared to previously published pre-vaccination data obtained between 2008 and 2010 in Galicia from women of the same age (18-26 years old, n = 523). The Stata 14.2 software was employed for statistical analyses.Data from 392 unvaccinated and 353 vaccinated women were compared. For unvaccinated and vaccinated women, HPV 16/18 prevalence was 9.2% and 0.8%, respectively, and HPV 31/33/45 prevalence was 8.4% and 1.1%, respectively. Direct, indirect and total effectiveness of the HPV vaccine were (%, 95% CI): 94 (72-99), 30 (-11-56) and 95 (79-99), respectively, for HPV 16/18 and 83 (46-94), -10 (-88-33) and 84 (54-94), respectively, for HPV 31/33/45. The number of women with first intercourse before 17 years old and 3 or more sexual partners along life was higher in the post-vaccination period (p < 0.05). A positive impact of bivalent HPV vaccine was observed, both on direct and cross protection. Sexual habits could have changed in the post-vaccination period.
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Affiliation(s)
- M. Jesus Purriños-Hermida
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Spain
- * E-mail: (MJPH); (AMP)
| | - María Isolina Santiago-Pérez
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Spain
| | - Mercedes Treviño
- Microbiology Department, University Hospital of Santiago, Santiago de Compostela, Spain
| | - Rafaela Dopazo
- Gynecology Department, University Hospital of Santiago, Santiago de Compostela, Spain
| | - Angelina Cañizares
- Microbiology Department, University Hospital of A Coruña, A Coruña, Spain
| | - Isolina Bonacho
- Gynecology Department, University Hospital of A Coruña, A Coruña, Spain
| | - Matilde Trigo
- Microbiology Department, University Hospital of Pontevedra, Pontevedra, Spain
| | - M. Eva Fernández
- Gynecology Department, University Hospital of Pontevedra, Pontevedra, Spain
| | - Ana Cid
- Microbiology Department, University Hospital of Ourense, Ourense, Spain
| | - David Gómez
- Gynecology Department, University Hospital of Ourense, Ourense, Spain
| | - Patricia Ordóñez
- Microbiology Department, University Hospital of Ferrol, Ferrol, Spain
| | - Amparo Coira
- Microbiology Department, University Hospital of Lugo, Lugo, Spain
| | - M. J. Armada
- Fingoy Primary Care Department, Sanitary Area of Lugo, Lugo, Spain
| | - Magdalena Porto
- Gynecology Department, University Hospital of Vigo, Vigo, Spain
| | - Sonia Perez
- Microbiology Department, University Hospital of Vigo, Vigo, Spain
- Galicia Sur Health Research Institute, Vigo, Vigo, Spain
| | - Alberto Malvar-Pintos
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, Spain
- * E-mail: (MJPH); (AMP)
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Paz-Zulueta M, Álvarez-Paredes L, Rodríguez Díaz JC, Parás-Bravo P, Andrada Becerra ME, Rodríguez Ingelmo JM, Ruiz García MM, Portilla J, Santibañez M. Prevalence of high-risk HPV genotypes, categorised by their quadrivalent and nine-valent HPV vaccination coverage, and the genotype association with high-grade lesions. BMC Cancer 2018; 18:112. [PMID: 29382323 PMCID: PMC5791190 DOI: 10.1186/s12885-018-4033-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 01/23/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The new nine-valent vaccine against human papillomavirus (HPV) includes the four HPV genotypes (6, 11, 16, and 18) that are targeted by the older quadrivalent HPV vaccine, plus five additional oncogenic types (31, 33, 45, 52, and 58) remain significantly associated with high grade lesions. We aimed to determine the prevalence of high-risk HPV genotypes in unvaccinated subjects and the association of these genotypes with the incidence of high-grade lesions. We also assessed which, if either, of these two HPV vaccines could have prevented these cases. METHODS This cross-sectional study, conducted from 4 January 2010 to 30 December 2011, was composed of 595 women attending the Hospital General Universitario de Elche (Spain) gynaecology department who were positively screened for opportunistic cervical cancer by pap smears and HPV detection during a routine gynaecological health check. The pap smear results were classified using the Bethesda system. HPV genotyping was performed with the Linear Array HPV genotyping test, and viruses were classified by the International Agency for Research on Cancer assessment of HPV carcinogenicity. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were estimated by logistic regression, adjusting for age and immigrant status. The prevented fraction among those exposed (PFe-adjusted) was determined as a measure of impact. RESULTS At least one of the additional five high-risk HPV genotypes present in the nine-valent HPV vaccine was detected in 20.5% of subjects. After excluding women with genotype 16 and/or 18 co-infection, high-risk genotypes (31, 33, 45, 52, and 58) were associated with a higher risk of intraepithelial lesion or malignancy: adjusted OR = 3.51 (95% CI, 1.29-9.56), PFe-adjusted = 0.72 (95% CI, 0.22-0.90). Genotypes that are still non-vaccine-targeted were detected in 17.98% of the women, but these were not significantly associated with high-grade lesions. CONCLUSION The greater protection of the nine-valent HPV vaccine is likely to have a positive impact because, in the absence of genotype 16 or 18 infection, these five genotypes on their own remained significantly associated with high-grade lesions.
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Affiliation(s)
- María Paz-Zulueta
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
| | - Ledicia Álvarez-Paredes
- Department of Microbiology and Parasitology, University Hospital of Burgos, C/ Islas Baleares, 3 - C.P.: 09006, Burgos, Spain
| | - Juan Carlos Rodríguez Díaz
- Department of Microbiology, University General Hospital of Alicante. Pintor Baeza, 11- C.P.: 03010, Alicante, Spain
| | - Paula Parás-Bravo
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
| | - Ma. Encarnación Andrada Becerra
- Department of Pathological Anatomy, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - José María Rodríguez Ingelmo
- Department of Gynecology, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - María Montserrat Ruiz García
- Department of Microbiology, University General Hospital of Elche. Camí de l’Almazara, 11 – C.P.: 03203, Alicante, Spain
| | - Joaquín Portilla
- Department of Infectious Diseases, University Hospital of Alicante. Pintor Baeza, 11- C.P.: 03010, Alicante, Spain
| | - Miguel Santibañez
- Faculty of Nursing, University of Cantabria, Avda Valdecilla s/n. C.P.: 39008, Cantabria, Spain
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5
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Dorsey ER, Wagner JD, Bull MT, Rizzieri A, Grischkan J, Achey MA, Sherer T, Chowdhury S, Meunier C, Cappelletti L, Rocker C, Richard IH, Schwarz H, Kang G, Ahmad SH, Biemiller RA, Biglan KM. Feasibility of Virtual Research Visits in Fox Trial Finder. JOURNAL OF PARKINSONS DISEASE 2016; 5:505-15. [PMID: 26406130 PMCID: PMC4923707 DOI: 10.3233/jpd-150549] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Fox Trial Finder is an online registry for individuals with and without Parkinson disease (PD) interested in participating in PD research. However, distance or disability could prevent such individuals from participating in traditional, clinic-based research at major centers. Objective: Use videoconferencing to connect participants to specialists to: (1) demonstrate feasibility of virtual research visits within this population (2) collect phenotypic data of the participants, (3) validate self-reported diagnosis, and (4) gauge interest in virtual research visits. Methods: We solicited volunteers throughout the United States through Fox Trial Finder. Interested individuals with PD provided consent, were given web cameras if needed, completed baseline surveys, and downloaded videoconferencing software remotely. Participants had a test connection and assessment appointment which included the Montreal Cognitive Assessment (MoCA), then a virtual research visit with a neurologist who reviewed their history and assessed their PD using a modified Movement Disorders Society Unified Parkinson’s Disease Rating Scale. Neurologists assessed PD diagnosis and symptomatology. Physicians and participants were surveyed about their experience. Results: Of 204 individuals who consented, 166 (81% ) individuals from 39 states completed all visits. The mean age was 62 and mean disease duration was 8.0 years. Mean MoCA score was 26.5, and mean modified MDS-UPDRS motor score was 22.8 (out of a possible 124). Neurologists judged PD as the most likely diagnosis in 97% of cases. Overall satisfaction with the visits was 79% (satisfied or very satisfied) among neurologists and 93% among participants. Conclusions: Through virtual research visits, neurologists engaged, characterized, and validated self-reported diagnosis in individuals with PD over a broad geography. This model may facilitate future research participation.
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Affiliation(s)
- E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States.,CHET, University of Rochester Medical Center, Rochester, New York, United States
| | | | - Michael T Bull
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States
| | | | - Justin Grischkan
- University of Rochester School of Medicine and Dentistry, Rochester, New York, United States
| | - Meredith A Achey
- CHET, University of Rochester Medical Center, Rochester, New York, United States
| | - Todd Sherer
- The Michael J. Fox Foundation For Parkinson's Research, New York, United States
| | - Sohini Chowdhury
- The Michael J. Fox Foundation For Parkinson's Research, New York, United States
| | - Claire Meunier
- The Michael J. Fox Foundation For Parkinson's Research, New York, United States
| | - Lily Cappelletti
- The Michael J. Fox Foundation For Parkinson's Research, New York, United States
| | - Charlotte Rocker
- The Michael J. Fox Foundation For Parkinson's Research, New York, United States
| | - Irene H Richard
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States
| | - Heidi Schwarz
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States
| | - Gail Kang
- University of California Berkeley, Berkeley, California, United States
| | - Stacy H Ahmad
- Department of Cell Biology and Pathology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Rachel A Biemiller
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States
| | - Kevin M Biglan
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States.,CHET, University of Rochester Medical Center, Rochester, New York, United States
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6
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Paz-Zulueta M, Fernández-Feito A, Amparán Ruiz M, Azofra Olave A, Martín Seco Y, Ojugas Zabala S, Otero García A, Royano Rasines C, Sarabia-Lavín R, Torres Manrique B, Santibáñez Margüello M. [Prevalence of non-vaccinable high risk genotypes of human papillomavirus in the Early Detection of Cervical Cancer Program in Cantabria]. Aten Primaria 2015; 48:347-55. [PMID: 26522783 PMCID: PMC6877849 DOI: 10.1016/j.aprim.2015.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/13/2015] [Accepted: 07/22/2015] [Indexed: 11/30/2022] Open
Abstract
Objetivo Estimar la prevalencia de infección por genotipos del virus del papiloma humano (VPH) de alto riesgo no vacunables. Diseño Estudio descriptivo transversal. Emplazamiento Siete centros de salud de Cantabria seleccionados aleatoriamente. Participantes Se incluyó a todas las mujeres con una citología vaginal valorable (n = 3.359) entre 2010-2011. Mediciones principales Se recogieron diagnóstico citológico, resultado de PCR y método anticonceptivo. Los resultados de las citologías se clasificaron con el sistema Bethesda. Para la tipificación de VPH según el riesgo oncogénico se utilizó la clasificación de Muñoz et al. Se estimaron proporciones y odds ratio (OR) con sus correspondientes intervalos de confianza al 95% (IC95%). Resultados La prevalencia de infección por VPH fue del 2,71% (IC95%: 2,15-3,27). La prevalencia de genotipos de VPH de alto riesgo oncogénico fue del 2,26%; (IC95%: 1,75-2,78). El genotipo más frecuente fue el 16 (28,89%). Más de la mitad de las mujeres fueron positivas para algún genotipo de alto riesgo no vacunable: 51 (18,89%) o 58 (13,33%) o 68 (12,22%) o 31 (11,11%). En el 23,33% de las mujeres coexistieron al menos 2 genotipos de alto riesgo no vacunables. Las mujeres más jóvenes (≤ 30 años) tuvieron 2 veces más riesgo de infección por cualquier VPH: OR 2,01; (IC95%: 1,02-3,96); y 2 veces más probabilidad de usar anticonceptivos hormonales frente al preservativo: OR 2,09; (IC95%: 1,64-2,67). Conclusiones Atendiendo al alto porcentaje de VPH de alto riesgo oncogénico no vacunable, habría que replantear la estrategia de prevención en la población, que podría tener una falsa sensación de protección.
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Affiliation(s)
- María Paz-Zulueta
- Departamento de Enfermería, Universidad de Cantabria, Cantabria, España.
| | - Ana Fernández-Feito
- Área de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Asturias, España
| | - Marina Amparán Ruiz
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, España
| | | | - Yolanda Martín Seco
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, España
| | - Sonia Ojugas Zabala
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, España
| | - Aurora Otero García
- Gerencia de Atención Primaria, Servicio Cántabro de Salud, Cantabria, España
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