Human Papillomavirus Genotype Distribution in Low-Grade Cervical Lesions: Comparison by Geographic Region and with Cervical Cancer

Abstract

Low-grade squamous intraepithelial lesions (LSIL) associated with certain human papillomavirus (HPV) genotypes may preferentially progress to cervical cancer. HPV genotyping may thus have the potential to improve the effectiveness of screening programs and to reduce overtreatment. LSIL cases (n = 8,308) from 55 published studies were included in a meta-analysis. HPV genotype distribution was assessed by geographic region and in comparison with published data on cervical squamous cell carcinoma (SCC). HPV detection in LSIL was 80% in North America but less than 70% in other regions, most likely reflecting regional differences in LSIL diagnosis. Among 5,910 HPVpositive LSILs, HPV16 was the most common genotype (26.3%) followed by HPV31 (11.5%), HPV51 (10.6%), and HPV53 (10.2%). HPV-positive LSILs from Africa were 2-fold less likely to be infected with HPV16 than those in Europe, and HPV-positive LSILs from North America were more likely to be infected with HPV18 than those from Europe or South/Central America. Interpretation for rarer genotypes was hampered by variation in HPV testing methodology. SCC/LSIL prevalence ratios indicated that HPV16 was 2-fold and HPV18 was 1.5-fold more common in SCC than in HPV-positive LSIL, thus appearing more likely to progress than other high-risk genotypes (SCC/LSIL prevalence ratios between 0.05 and 0.85). HPV53 and HPV66 showed SCC/LSIL ratios of 0.02 and 0.01, respectively. HPV genotype distribution in LSIL differs from that in cervical cancer, highlighting the importance of HPV genotype in the risk of progression from LSIL to malignancy. Some regional differences in the relative importance of HPV genotypes in LSIL were noted.

Circulation of human papillomavirus (HPV) genotypes in women from Córdoba, Argentina, with squamous intraepithelial lesions

“…Although the high percentage of HR-HPV in LSIL coincides with the results of a meta-analysis carried out in different regions of the world 8 , there is no evidence of a statistically significant difference, thus suggesting that both LR-HPV and HR-HPV can be found in this lesion.…”

A comprehensive evaluation of the accuracy of cervical pre-cancer detection methods in a high-risk area in East Congo

“…However, in the meta-analyses performed by Clifford et al (2003b), it is indicated that the five types, HPV 16,18,31,33 and 45, are the most predominant HPV types detected in high-grade cervical neoplasia and comprise almost 97% of the HPV DNA types detected in cervical carcinomas in Europe and Northern America. The number is compensated for multiple infections (Clifford et al, 2003b(Clifford et al, , 2005. There are also strong indications that the same five types are the most predominant ones in cervical carcinomas in the rest of the world (Munoz et al, 2004;Smith et al, 2007).…”

Human papillomavirus infection: an Anonymous Prevalence Study in South Wales, UK

“…HPV 16 and 18 are associated with an increased risk of progression to cervical neoplasia (Clifford et al, 2003(Clifford et al, , 2005b. However, the incidence of different HPV types in cervical cancers has been found to vary with different geographical populations (Bosch et al, 1995).…”