Prevalence and Risk Factors of Human Papillomavirus (HPV) Infection in Southern Chinese Women – A Population-Based Study

Background: Persistent high-risk type Human papillomavirus (HPV) infection is recognized as a necessary cause of cervical cancer. This study aimed to compare the HPV prevalence and risk factors between women residing in Hong Kong (HK) and Guangzhou (GZ) region of China. Methodology/Principal Findings: A total of 1,570 and 1,369 women were recruited from HK and GZ, respectively. The cytology samples were collected and tested for HPV infection. The overall and type-specific HPV prevalence and the potential risk factors for acquisition of HPV infection were studied. Women with normal cytology in the GZ cohort had significantly higher HPV prevalence (10%) than those in the HK cohort (6.2%, p<0.001). The patterns of the age-specific HPV prevalence were also different between the two cohorts. In the HK cohort, women at the age of 20-29 years old had the highest prevalence and a second peak was observed in the age of ≥60 years old. In the GZ cohort, the highest HPV prevalence was also observed in 20-29 years old but declined as the age increased and a second peak was not seen. HPV16 and HPV52 were the most common high-risk types found in the HK and GZ cohorts, respectively. Age was the most consistently observed independent risk factor for HPV infection in the HK, while the number of sexual partners had association in the GZ cohort. Conclusions/Significance: Our study provides the current status and the epidemiological characteristics of HPV prevalence in Southern Chinese women. The results strongly suggested that population education and the effective cervical cancer screening would be vital in the prevention of cervical cancer. © 2011 Liu et al.published_or_final_versio

Potential risk factors in relation to HPV infection in the HK and GZ cohorts.

1<p>:Tolerance >0.4 for all variables, Naglekerke R² = 7.8%, Hosmer-Lemeshow test p = 0.793.</p>2<p>:Tolerance >0.4 for all variables, Naglekerke R² = 3.5%, Hosmer-Lemeshow test p = 0.750.</p>3<p>:OR and P-value were obtained using multivariate logistic regression analysis model of which included all of the variables listed in this table. Bold type indicated statistically significant values.</p><p>N: Total number of cases.</p

The prevalence of type-specific HPV infection in women with normal cytology in the HK and GZ cohorts.

<p>*Statistically significant at 0.05 level of significance by Holm's procedure that accounts for the multiple comparisons.</p><p>**Adjusted for the stratified sampling design.</p>†<p>The seven commonest HPV high-risk types in the HK cohort.</p>‡<p>The seven commonest HPV high-risk types in the GZ cohort.</p

Comparison of the age-specific overall and high-risk HPV prevalence in five age-groups in the HK and GZ cohorts.

<p>(A) Overall HPV prevalence: significant difference in the overall HPV prevalence between the two cohorts in age-groups of 30–39, 40–49 and 50–59 (p<0.001, p<0.001 and p = 0.007, respectively, z test). (B) High-risk HPV prevalence: significant difference in the high-risk HPV prevalence between the two cohorts in age-groups of 30–39 and 40–49 (p<0.001 and p<0.001, respectively, z test). The error bar indicates 95% confidence interval.</p