Genital Human Papillomavirus Infection among Women in Bangladesh: Findings from a Population-Based Survey

Abstract

BackgroundThere has been no population-based study on human papillomavirus (HPV) prevalence or its genotypes in Bangladesh; a country eligible for GAVI funding for HPV vaccine.MethodsWe used baseline survey data of a prospective cohort study that was conducted in one urban and one rural area of Bangladesh. A total of 997 urban and 905 rural married women, aged 13 to 64 years, were enrolled in the baseline during July-December, 2011. Information was collected on socio-demographic characteristics and potential risk factors for HPV infection followed by gynecological examination and collection of endocervical samples using the cervical cytobrush (Digene cervical sampler). HPV DNA testing was done by Polymerase Chain Reaction (PCR) using a consensus primer set.ResultsPrevalence of any HPV infection was 7.7% with no significant difference between urban and rural women. Most common high-risk genotypes were HPV16, HPV66, HPV18, HPV45, HPV31 and HPV53. Urban women working as housemaids or garment workers were at higher risk of any HPV infection (OR = 2.15, 95% CI: 1.13–4.11) compared to housewives. Rural women whose husband lived overseas were almost two times more likely to have any HPV infection (OR = 1.93; 95% CI 1.05–3.55) compared to women whose husbands lived with them.ConclusionThe prevalence of HPV infection among Bangladeshi women is similar to other regions of Asia. However, type-specific patterns are different. The study findings will inform the formulation of HPV vaccination policies in Bangladesh, monitoring the impact of vaccination programmes, and the identification of target populations for screening.

Human papillomavirus infection among Bangladeshi women with cervical intraepithelial neoplasia and chronic cervicitis

“…All CIN grade 2 and 3 cases were positive for HPV while >50% was positive in CIN1. The rate of HPV infection was significantly low in chronic cervicitis (18.2%) but it was comparatively higher than that in women with normal cervical cytology [12]. Studies in different countries of Africa reported similar high rate of HPV infection in different grade of CIN [6].…”

“…A previous study in Bangladesh has reported the presence of high risk HPV type (16, 18, 31 and 45) in about 56% of women with high risk behavior [13]. Similarly, a population based study in Bangladesh also found the prevalence of high risk HPV types among women with normal cytology [12].…”

“…The prevalence of HPV infection in women with normal cervical cytology ranged from 6.7% to 11.4% in China, Nepal, Thailand and Indonesia [8][9][10][11]. A community based study in Bangladesh has reported a prevalence of HPV infection as 7.7% in women with normal cytology [12] while the overall rate is 49.1% among the Bangladeshi sex workers [13]. There is little information regarding the prevalence of HPV infection in Bangladeshi women with cervical dysplasia and cancer.…”

Detection of Genital HPV Infection Using Urine Samples: a Population Based Study in India

“…These studies show that with literacy, better adoption of family planning practices and genital hygiene a reduction in HPV infection is achievable. Perdoor village in Udupi district shows a higher female literacy rate and better standards of living compared to the rest of India (Nair et al, 2000). Prevalence study carried out in North India found higher prevalence among rural women following non vegetarian diet and using homemade pads during menstruation (Srivastava et al, 2012).…”

“…Multiple sexual partners increase the risk of incident as well as persistent HPV infections (Mollers et al, 2013). Women with 4 or more sexual partners were almost four times more at risk of having any HPV infection compared to women with single partner (Nahar et al, 2014). The causal association of HPV with cervical cancer is well accepted and the incidence of cervical cancer cases can be related with HPV prevalence in that area.…”