Risk factors for human papilomavirus infection among women in Portugal: the CLEOPATRE Portugal Study

OBJECTIVE: Human papillomavirus (HPV) is responsible for a range of diseases, including cervical cancer. The primary objectives of the CLEOPATRE Portugal study were to estimate the overall and age-stratified prevalence of cervical HPV infection and to assess HPV prevalence and type-specific distribution by cytological results among women aged 18 to 64 years, who reside in mainland Portugal. MATERIALS AND METHODS: This cross-sectional population-based study recruited women aged 18 to 64 years, according to an age-stratified sampling strategy, who attended gynecology/obstetrics or sexually transmitted disease clinics across the 5 regional health administrations in mainland Portugal between 2008 and 2009. Liquid-based cytology samples were collected and analyzed centrally for HPV genotyping (clinical array HPV 2 assay) and cytology. Prevalence estimates were adjusted for age using 2007 Portuguese census data. RESULTS: A total of 2326 women were included in the study. The overall prevalence of HPV infection in the study was 19.4% (95% confidence interval, 17.8%-21.0%), with the highest prevalence in women aged 18 to 24 years. High-risk HPV types were detected in 76.5% of infections, of which 36.6% involved multiple types. The commonest high-risk type was HPV-16. At least 1 of the HPV types 6/11/16/18 was detected in 32.6% of infections. The HPV prevalence in normal cytology samples was 16.5%. There was a statistically significant association between high-risk infection and cytological abnormalities (P < 0.001). CONCLUSIONS: This is the first population-based study to quantify and describe cervical HPV infection in mainland Portugal. This study provides baseline data for future assessment of the impact of HPV vaccination programs

Prevalence of Human Papillomavirus Infection in Women in Portugal - The CLEOPATRE Portugal Study

Objective: Human papillomavirus (HPV) is responsible for a range of diseases, including cervical cancer. The primary objectives of the CLEOPATRE Portugal study were to estimate the overall and age-stratified prevalence of cervical HPV infection, and to assess HPV prevalence and type-specific distribution by cytological results, among women aged 18–64 years resident in mainland Portugal. Methods/materials: This cross-sectional, population-based study recruited women aged 18–64 years, according to an age-stratified sampling strategy, who attended gynaecology/obstetrics or sexually transmitted disease clinics across the five Regional Health Administrations in mainland Portugal between 2008 and 2009. Liquid-based cytology samples were collected and analysed centrally for HPV genotyping (Clinical Array HPV 2 assay) and cytology. Prevalence estimates were adjusted for age using 2007 Portuguese census data. Results: A total of 2326 women were included in the study. The overall prevalence of HPV infection in the study was 19.4% (95% CI, 17.8–21.0), with the highest prevalence in women aged 18–24 years. High-risk HPV types were detected in 76.5% of infections, of which 36.6% involved multiple types. The commonest high-risk type was HPV 16. At least one of the HPV types 6/11/16/18 was detected in 32.6% of infections. The HPV prevalence in normal cytology samples was 16.5%. There was a statistically significant association between high-risk infection and cytological abnormalities (p<0.001). Conclusions: This is the first population-based study to quantify and describe cervical HPV infection in mainland Portugal. This study provides baseline data for future assessment of the impact of HPV vaccination programmes.Sanofi Pasteur MS

Risk factors for human papillomavirus infection among women in Portugal: The CLEOPATRE Portugal Study

Objective: To investigate demographic, socioeconomic, lifestyle, and medical factors that might predispose women to cervical human papillomavirus (HPV) infection. Method: A cross-sectional population-based study was performed. Women aged 18–64 years who attended selected obstetrics and gynecology or sexually transmitted disease (STD) clinics in mainland Portugal between February 2008 and March 2009 were recruited, according to an age-stratified sampling strategy. Liquid-based cytology samples were analyzed centrally for HPV genotype and for cytologic features. Univariate and multivariate logistic regression analyses identified risk factors for HPV infection. Results: Among the 2326 women evaluated, the crude prevalence of HPV infection was 19.4%. Lifetime number of sexual partners was a strong predictor of HPV infection (odds ratio 5.44 for 5–10 partners versus 1 partner; Pb0.001). Other risk factors were young age (particularly among women aged 20–24 years; Pb0.001); country of birth other than mainland Portugal (P=0.002); education up to secondary school level (P=0.010); smoking history (≤10 years; P=0.004); and any STD in the past 12 months (P=0.052). Conclusion: Data from the present study may aid identification of women at increased risk of HPV infection and target prevention strategies.Sanofi Pasteur MS