Genital Human Papillomavirus Infection in women from Florianópolis - Santa Catarina, Brazil

Authors

DOI:

https://doi.org/10.5327/DST-2177-8264-2023351374%20

Keywords:

Papillomaviridae, HPV types, Ututerine cervical neoplasm, vaccination coverage

Abstract

Introduction: Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in women. About 80% of sexually active women will have contact with this virus at some age in their lives. Most infections will be transient, but when the infection becomes persistent, associated with high oncogenic risk HPV, there may be progression to cancer, especially cervical cancer. The best way to prevent HPV infection is through the use of vaccines. Objective: To assess which are the most prevalent types of HPV in the city of Florianópolis, Brazil and if the majority of the diagnosed types are contained in the HPV vaccines currently available on the market and in the public health sector. Methods: More than 14,727 HPV tests were evaluated for the diagnosis of genital HPV infection in women from Florianópolis. The prevalence of infection was evaluated according to age of the women. HPV detection was performed using molecular biology tests, such as hybrid capture (for diagnosis of the HPV group, high or low oncogenic risk) and PCR (viral genotyping) techniques. Results: The diagnosis of HPV infection was made for women between one and 102 years of age. The highest positivity of the exams was observed in women aged 20–25 years (51% of the exams). The most prevalent age group was 31–35 years old (23.5%), and the lowest was for women aged 70 and above (0.6%). High oncogenic risk HPV was detected in 94.1% of positive samples and was the most frequent in all age groups. Mixed infection (high- and low-risk HPV) was more prevalent in the 66–70 age group (25.6%). The most frequent genotypes were non-16/18 high oncogenic risk HPV (77% of positive cases). HPV 16 was found in 17.1% of positive cases, and HPV 18 in 6.5%. Conclusion: The most prevalent types of HPV in Florianópolis in the last 6 years are non-16/18 high oncogenic risk HPV types, viral types not covered by the current HPV vaccine available in the public health sector in Brazil.

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References

Burchell NA, Winer RL, Sanjosé S, Franco EL. Chapter 6: Epidemiology and transmission dynamics of genital HPV infection. Vaccine. 2006;24(Suppl 3):S52-61. https://doi.org/10.1016/j.vaccine.2006.05.031

Muñoz N, Castellsagué X, Berrington de González A, Gissmann L. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006;24(Suppl 3):S1-10. https://doi.org/10.1016/j.vaccine.2006.05.115

Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006;24(Suppl 1):S1-15. https://doi.org/10.1016/j.vaccine.2005.09.054

Muñoz N, Bosch FX, Sanjose S, Herrero R, Castellagué X, Shah KV, et al. Epidemiologic classification of Human papillomavirus types associated with cervical carcinoma. N Engl J Med. 2003;348(6):518-27. https://doi.org/10.1056/NEJMoa021641

Castellsagué X, Bosch FX, Muñoz N. Environmental co-factors in HPV carcinogenesis. Virus Res. 2002;89(2):191-9. https://doi.org/10.1016/s0168-1702(02)00188-0

Carvalho MO, Almeida RW, Leite FM, Fellows IB, Teixeira MH, Oliveira LH, et al. Detection of Human papillomavirus DNA by the hybrid capture assay. Braz J Infect Dis. 2003;7(2):121-5. https://doi.org/10.1590/s1413-86702003000200004

Franco EL, Villa LL, Sobrinho JP, Prado JM, Rousseau MC, Desy M, et al. Epidemilogy of acquisition and clearence of cervical human papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis. 1999;180(5):1415-23. https://doi.org/10.1086/315086

Fernandes JV, Meissner RV, Carvalho MGF, Fernandes TAAM, Azevedo PRM, Villa LL. Prevalence of HPV infection by cervical cytologic status in Brazil. Int J Gynecol Obstet. 2009;105:21-4. https://doi.org/10.1016/j.ijgo.2008.12.004

Fedrizzi EN, Schlup CG, Menezes ME, Ocampos M. Infecção pelo Papilomavírus humano (HPV) em mulheres de Florianópolis, Santa Catarina. J Bras Doenças Sex Transm. 2008;20(2):73-9. https://doi.org/10.5327/DST-2177-8264-2023351211

Parkin DM, Bray F, Ferlay J, Pisani P. Global Cancer Statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108. https://doi.org/10.3322/canjclin.55.2.74

Giraldo PC, Silva MJPMA, Fedrizzi EN, Gonçalves AKS, Amaral RLG, Eleutério Júnior J, et al. Prevenção da infecção por HPV e lesões associadas com o uso de vacinas. J Bras Doenças Sex Transm. 2008;20(2):132-40. https://doi.org/10.17765/1983-1870.2018v11n3p431-440

Clifford GM, Gallus S, Herrero R, Muñoz N, Snijders PJ, Vaccarella S, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet. 2005;366(9490):991-8. https://doi.org/10.1016/S0140-6736(05)67069-9

Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Nuñoz N, et al. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis. 2007;7:453-9. https://doi.org/10.1016/S1473-3099(07)70158-5

World Health Organization (WHO). Comprehensive cervical cancer control. A guide to essential practice. 2nd ed. Geneva: WHO; 2014 [cited on Jun 14, 2023]. Available from: https://apps.who.int/iris/bitstream/handle/10665/144785/9789241548953_eng.pdf

Instituto Nacional do Câncer (INCA) /Ministério da Saúde (MS). Câncer do Colo de útero – Incidência. [cited on Jun 16, 2023]. Available from: https://www.gov.br/inca/pt-br/assuntos/gestor-e-profissional-de-saude/controle-do-cancer-do-colo-do-utero/dados-e-numeros/incidencia

Harper DM. Prophylactic human papillomavirus vaccines to prevent cervical cancer: review of the Phase II and III trials. Therapy. 2008;5(3):313-24. https://doi.org/10.2217/14750708.5.3.313

Kang WD, Choi HS, Kim SM. Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN 2/3)? Gynecol Oncol. 2013;130(2):264-8. https://doi.org/10.1016/j.ygyno.2013.04.050

Paavonen J, Jenkins D, Bosch FX, Naud P, Salmerón J, Wheeler CM, et al. Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a Phase III double-blind, randomized controlled trial. Lancet. 2007;369(9580):2161-70. https://doi.org/10.1016/S0140-6736(07)60946-5

Villa LL, Costa RCR, Petta CA, Andrade RP, Ault KA, Giuliano AR et al. Prophylactic quadrivalent Human papillomavirus (Types 6, 11, 16 and 18) l1 virus-like particle vaccine in young women: a randomized double-blind placebo-controlled multicenter phase II efficacy trial. Lancet Oncology. 2005;6(5):271-8. https://doi.org/10.1016/S1470-2045(05)70101-7

Ault KA, Future II Study Group. Effect of a prophylactic Human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3 and adenocarcinoma in situ: A combined analysis of four randomized clinical trials. Lancet. 2007;369:1861-8. https://doi.org/10.1016/S0140-6736(07)60852-6

Muñoz N, Manalastas Junior R, Pitisuttithum P, Tresukosol D, Monsonego J, Ault K, et al. Safety, immunogenicity, and efficacy of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in women aged 24-45 years: a randomised, double-blind trial. Lancet. 2009;373(9679):1949-57. https://doi.org/10.1016/S0140-6736(09)60691-7

Skinner SR, Szarewski A, Romanowski B, Garland SM, Lazcano-Ponce E, Salmerón J, et al. Efficacy, safety, and immunogenicity of the Human papillomavirus 16/18 AS04-adjuvanted vaccine in women older than 25 years: 4-year interim follow-up of the phase 3, double-blind, randomized controlled VIVIANE study. Lancet 2014;384:2213–27. https://doi.org/10.1016/S0140-6736(14)60920-X

Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711-23. https://doi.org/10.1056/NEJMoa1405044

Programa Nacional de Imunizações, Ministério da Saúde do Brasil. Informe técnico sobre a vacina contra o Papilomavírus humano (HPV) na atenção básica. Brasília, fevereiro de 2015 [cited on Jun 12, 2023]. Available from: http://lproweb.procempa.com.br/pmpa/prefpoa/sms/usu_doc/informe_tecnico__hpv_2015.pdf

Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância das Doenças Transmissíveis, Coordenação Geral do Programa Nacional de Imunizações. Nota Informativa referente às mudanças no Calendário Nacional de Vacinação para o ano de 2017. Brasília, fevereiro de 2017 [cited on Jun 12, 2023]. Available from: https://www.saude.go.gov.br/files/imunizacao/legislacao/NI384(MudancasnoCalendarioNacionaldeVacinacao2017).pdf

Anvisa. Registrada vacina do HPV contra 9 subtipos do vírus. [cited on Jun 12, 2023]. Available from: http://antigo.anvisa.gov.br/resultado-de-busca?p_p_id=101&p_p_lifecycle=0&p_p_state=maximized&p_p_mode=view&p_p_col_id=column-1&p_p_col_count=1&_101_struts_action=%2Fasset_publisher%2Fview_content&_101_assetEntryId=3875990&_101_type=content&_101_groupId=219201&_101_urlTitle=registrada-vacina-do-hpv-contra-9-subtipos-do-virus&inheritRedirect=true

Fernandes S. Vital para evitar câncer, nova vacina para o HPV é lançada no Brasil. Folha de São Paulo [Internet]. 2023 Mar 9 [cited 2023 Jun 12]; Equilíbrio e Saúde. Available from: https://www1.folha.uol.com.br/equilibrioesaude/2023/03/vital-para-evitar-cancer-nova-vacina-para-hpv-e-lancada-no-brasil.shtml

Fedrizzi EN, Steffens SM, Menezes ME, Levi JE. Genital infection by Human Papillomavirus (HPV) in women from Santa Catarina/Brazil. J Bras Doenças Sex Transm. 2022;34:e22112. https://doi.org/10.5327/DST-2177-8264-20221212

Wendland EM, Villa LL, Unger ER, Domingues CM, Benzaken AS; POP Brazil Study Group. Prevalence of HPV infection among sexually active adolescents and young adults in Brazil: The POP-Brazil Study. Sci Rep. 2020;10(1):4920. https://doi.org/10.1038/s41598-020-61582-2

Nicolosi A, Laumann EO, Glasser DB, Moreira Júnior ED, Paik A, Gingell C. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004;64(5):991-7. https://doi.org/10.1016/j.urology.2004.06.055

Kjaer SK, Svare EI, Worm AM, Walboomers JMM, Meijer CJLM, van den Brule AJC. Human papillomavirus infection in Danish female sex workers: decreasing prevalence with age despite continuously high sexual activity. Sex Transm Dis. 2000;27:438-45. https://doi.org/10.1097/00007435-200009000-00003

Colpani V, Falcetta FS, Bidinotto AB, Kops NL, Falavigna M, Hammes LS, et al. Prevalence of human papillomavirus (HPV) in Brazil: a systematic review and meta-analysis. PLoS ONE. 2020;15(2):e0229154. https://doi.org/10.1371/journal.pone.0229154

Rousseau MC, Pereira JS, Prado JC, Villa LL, Rohan TE, Franco EL. Cervical coinfection with human papillomavirus (HPV) types as a predictor of acquisition and persistence of HPV infection. J Infect Dis. 2001;184(12):1508-17. https://doi.org/10.1086/324579

Winer RL, Hughes JP, Feng Q, Xi LF, Cherne SL, Oreilly S, et al. Early natural history of incident type-specific human papillomavirus infections in newly sexually active Young women. Cancer Epidemiol Biomarkers Prev. 2011;20(4):699-707. https://doi.org/10.1158/1055-9965.EPI-10-1108

Fernandes JV, Meissner RV, Carvalho MG, Fernandes TA, Azevedo PR, Villa LL. Prevalence of HPV infection by cervical cytologic status in Brazil. Int J Gynaecol Obstet. 2009;105(1):21-4. https://doi.org/10.1016/j.ijgo.2008.12.004

Bruni L, Diaz M, Castellsague X, Ferrer E, Bosch FX, Sanjose S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis. 2010;202(12):1789-99. https://doi.org/10.1086/657321

Silva MFB, Chagas BS, Guimarães V, Katz LM, Felix PM, Miranda PM, et al. HPV31 and HPV33 incidence in cervical samples from women in Recife, Brazil. Genet Mol Res. 2009;8(4):1437-43. https://doi.org/10.4238/vol8-4gmr677

Rabelo-Santos SH, Zeferino L, Villa LL, Sobrinho JP, Amaral RG, Magalhaes AV. Human papillomavirus prevalence among women with cervical intraepithelial neoplasia III and invasive cervical cancer from Goiania, Brazil. Mem Inst Oswaldo Cruz. 2003;98(2):181-4. https://doi.org/10.1590/s0074-02762003000200003

Tozetti IA, Scapulatempo IDL, Kawski VL, Ferreira AW, Levi JE. Multiple types of human papillomavirus in cervical samples in women in Campo Grande, MS, Brazil. BJID. 2006;10(5):309-10. https://doi.org/10.1590/s1413-86702006000500001

Castilho JL, Levi JE, Luz PM, Cambou MC, Vanni T, Andrade A, et al. A cross-sectional study of high-risk human papillomavirus clustering and cervical outcomes in HIV-infected women in Rio de Janeiro, Brazil. BMC Cancer. 2015;15:478. https://doi.org/10.1186/s12885-015-1486-4

Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Brazil. 2021 [cited on Jun 24, 2023]. Available from: https://hpvcentre.net/statistics/reports/BRA.pdf

Noronha V, Mello W, Villa L, Brito A, Macedo R, Bisi F, et al. Human papillomavirus associated with uterine cervix lesions. Rev Soc Bras Med Trop. 1999;32(3):235-40. Available from: https://www.scielo.br/j/rsbmt/a/7WpwgK964pGpDdHHdnG6w3j/?format=pdf&lang=pt

Eluf-Neto J, Booth M, Munoz N, Bosch FX, Meijer CJ, Walboomers JM. Human papillomavirus and invasive cervical cancer in Brazil. Br J Cancer. 1994;69(1):114-9. https://doi.org/10.1038/bjc.1994.18

Oliveira-Silva M, Lordello CX, Zardo LM, Bonvicino CR, Moreira MA. Human Papillomavirus in Brazilian women with and without cervical lesions. Virol J. 2011;8:4. https://doi.org/10.1186/1743-422X-8-4

Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007;297(8):813-9. https://doi.org/10.1001/jama.297.8.813

Wheeler CM, Hunt WC, Cuzick J, Lansfeld E, Pearse A, Montoya GD, et al. A population-based study of human papillomavirus genotype prevalence in the United States: baseline measures prior to mass human papillomavirus vaccination. Int J Cancer. 2013;132:198-207. https://doi.org/10.1002/ijc.27608

Mendoza LP, Arbiza J, Paez M, Kasamatsu E, Castro A, Giménez G, et al. Distribution of human papillomavirus genotypes in Paraguayan women according to the severity of the cervical lesion. J Med Virology. 2011;83:1351-7. https://doi.org/10.1002/jmv.22112

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Published

2023-09-20

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Fedrizzi EN, Levi JE. Genital Human Papillomavirus Infection in women from Florianópolis - Santa Catarina, Brazil. DST [Internet]. 2023 Sep. 20 [cited 2024 Jun. 16];35. Available from: https://bjstd.org/revista/article/view/1374

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