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July 2006

Literature Review

Worldwide distribution of human papillomavirus types of cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis
Go to full text in PubMed: Clifford GM, Gallus S, Herrero R, et al. Lancet 2005;366:991

The report is from the International Agency for Research on Cancer (IARC) HPV prevalence surveys with a goal to compare HPV-type distribution in representative samples of women from 13 areas and 11 countries including sub-Saharan Africa, Asia, South America and Europe. The results are based on observations in 15,613 women age 15-74 who did not have cytologic abnormalities. The most common HPV type was 16 followed in rank order by 42, 58, 31, 18, 56, 81, 35, 33 and 45. There were a total of 1,429 positive specimens including 1250 with high risk types and 675 with low risk types. There were substantial regional differences between HPV prevalence and prevalence of specific types, such as HPV 16. These data are shown on the following table:

 Country/Area

Age standardized prevalence

Any HPV

HPV 16 in HPV positive cases

 Nigeria

25.6%

12.3%

 Asia

8.7%

18.4%

 S. America

14.3%

21.4%

 Europe

5.2%

25.5%

 All areas

10.5%

19.7%

The authors conclude that the distribution of HPV types in different populations need to be taken into account when developing tests for screening for HPV and for predicting the effect of vaccines on the incidence of infection. 

Comment: These data are obviously important in the context of the newly licensed HPV vaccine. 

Literature Review by John G. Barlett, M.D. Professor, Division of Infectious Diseases

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