Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region

Xavier Castellsagué, Kevin A Ault, F Xavier Bosch, Darron Brown, Jack Cuzick, Daron G Ferris, Elmar A Joura, Suzanne M Garland, Anna R Giuliano, Mauricio Hernandez-Avila, Warner Huh, Ole-Erik Iversen, Susanne K Kjaer, Joaquin Luna, Joseph Monsonego, Nubia Muñoz, Evan Myers, Jorma Paavonen, Punnee Pitisuttihum, Marc Steben, Cosette M Wheeler, Gonzalo Perez, Alfred Saah, Alain Luxembourg, Heather L Sings, Christine Velicer, Xavier Castellsagué, Kevin A Ault, F Xavier Bosch, Darron Brown, Jack Cuzick, Daron G Ferris, Elmar A Joura, Suzanne M Garland, Anna R Giuliano, Mauricio Hernandez-Avila, Warner Huh, Ole-Erik Iversen, Susanne K Kjaer, Joaquin Luna, Joseph Monsonego, Nubia Muñoz, Evan Myers, Jorma Paavonen, Punnee Pitisuttihum, Marc Steben, Cosette M Wheeler, Gonzalo Perez, Alfred Saah, Alain Luxembourg, Heather L Sings, Christine Velicer

Abstract

Background: We estimated the proportion of cervical intraepithelial neoplasia (CIN) cases attributed to 14 HPV types, including quadrivalent (qHPV) (6/11/16/18) and 9-valent (9vHPV) (6/11/16/18/31/33/45/52/58) vaccine types, by region METHODS: Women ages 15-26 and 24-45 years from 5 regions were enrolled in qHPV vaccine clinical trials. Among 10,706 women (placebo arms), 1539 CIN1, 945 CIN2/3, and 24 adenocarcinoma in situ (AIS) cases were diagnosed by pathology panel consensus.

Results: Predominant HPV types were 16/51/52/56 (anogenital infection), 16/39/51/52/56 (CIN1), and 16/31/52/58 (CIN2/3). In regions with largest sample sizes, minimal regional variation was observed in 9vHPV type prevalence in CIN1 (~50%) and CIN2/3 (81-85%). Types 31/33/45/52/58 accounted for 25-30% of CIN1 in Latin America and Europe, but 14-18% in North America and Asia. Types 31/33/45/52/58 accounted for 33-38% of CIN2/3 in Latin America (younger women), Europe, and Asia, but 17-18% of CIN2/3 in Latin America (older women) and North America. Non-vaccine HPV types 35/39/51/56/59 had similar or higher prevalence than qHPV types in CIN1 and were attributed to 2-11% of CIN2/3.

Conclusions: The 9vHPV vaccine could potentially prevent the majority of CIN1-3, irrespective of geographic region. Notwithstanding, non-vaccine types 35/39/51/56/59 may still be responsible for some CIN1, and to a lesser extent CIN2/3.

Trial registration: ClinicalTrials.gov NCT00092521 NCT00092534 NCT00090220.

Keywords: Adenocarcinoma in situ; Cervical cancer; Cervical intraepithelial neoplasia; Human papillomavirus.

Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Prevalence of cervical HPV infection at baseline by region, irrespective of co-infections, vaccine and placebo arms combined. Non=non-vaccine type (HPV35/39/51/56/59); qHPV=quadrivalent vaccine HPV type (HPV6/11/16/18); 9vHPV=9-valent vaccine HPV type (HPV6/11/16/18/31/33/45/52/58). Total data adapted from reference .
Fig. 2
Fig. 2
Percent of CIN1-3 attributed to the respective HPV types in women ages 15–26, by region, proportional method. Total data adapted from reference (4).
Fig. 3
Fig. 3
Percent of CIN1-3 attributed to HPV16/18, HPV 31/33/45/52/58, and HPV 35/39/51/56/59, by region, proportional method, in women ages 15–26 (panel A) and 24 to 45 (panel B). Only regions with >20 CIN2 or CIN3 lesions are shown.

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Source: PubMed

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