Human Papillomavirus Infection in Women in Puerto Rico

Abstract

Objective To describe the prevalence and concordance between cervical and anal HPV infection and compare cervicovaginal and anal self-collection methods for HPV testing between physician and self-collected specimens in women in Puerto Rico. Materials and Methods Specimens for HPV-DNA testing were obtained from 100 women aged 18-34 years attending a general gynecology clinic for a routine Pap smear. HPV testing was performed using PCR MY09/MY11 primers. Positive samples were typed for 39 genotypes. Agreement between sampling methods was determined by % agreement and the kappa statistic. Results 38.4% (38/99) of cervicovaginal and 33.7% (30/89) of anal physician-collected samples were HPV+, for the 39 genotypes evaluated; whereas, 35.1% (34/97) of cervicovaginal and 32.0% (31/97) of anal self-collected samples were positive. HPV-16 was the most common type identified in the cervix (8.3%, 8/97) and the anus (5.6%, 5/89) of physician-collected samples, with similar prevalence in self-collected samples. Concordance between cervical and anal HPV infection was high (>90%) for all HPV types evaluated. There was strong % agreement between physician and self-collected cervicovaginal and anal samples (>95% for all HPV types) and good-excellent agreement (kappa>0.60) for most HPV types. Conclusions The clinic-based prevalence of anal and cervicovaginal HPV infection was high, with strong concordance between cervical and anal infection and good to excellent agreement between physician and self-collected samples. This study supports the feasibility of utilizing cervical and anal self-sampling methods in future population-based studies of HPV infection in PR, and as an HPV screening method in women.

Prevalence of and Risk Factors for Oral Human Papillomavirus Infection among HIV-Positive and HIV-Negative People Who Inject Drugs

“…We found no evidence that illicit drug use itself is associated with oral HPV, consistent with another small study that considered the effects of marijuana, heroin, cocaine, crack, and speedball use on oral HPV [ 25 ]. This differs from findings for cervical HPV infection, which has been reported to be elevated among women who use crack or marijuana [ 26 ].…”

Feasibility and Acceptability of Anal Self-Sampling for Human Papillomavirus Screening in HIV-Infected Patients

“…When focusing on the 94 patients who accepted anal self-sampling and collected samples with appropriate cellularity, representing 81% of those included in the study, high-risk HPV were detected in approximately half of these individuals, and any HPV were detected in approximately three quarters of them. This overall HPV prevalence (76%) as well as the HPV16 (35%) and 18 (21%) prevalence rates found in our study are intermediate between those obtained by Lampinen et al [23] among 222 HIV-negative MSM (67, 22, and 8%, respectively) and those found by Ortiz et al [24] among 100 HIV-negative women whose age ranged from 18 to 34 years (52, 6, and 2%, respectively). No official guidelines currently recommend the use of HPV testing alone.…”

Cervicovaginal Fungi and Bacteria Associated With Cervical Intraepithelial Neoplasia and High-Risk Human Papillomavirus Infections in a Hispanic Population

“…Differences in HPV prevalence across studies may in part result from the different detection methods used. In Puerto Rico, the prevalence of HPV among urban women aged 18–34 years-old has been reported to be 38.4% in cervical samples and 33.7% in anal physician-collected samples ( Ortiz et al, 2013 ). However, we found in this high-risk urban Hispanic population, a very high HPV prevalence (84%) in cervical lesions (mainly high-risk HPV-types) using the LiPA kit.…”

“…Puerto Ricans also have substantial economic and access barriers to treatments, including poor insurance coverage and even fewer credentialed radiotherapy machines island-wide ( Kunos et al, 2018 ). Puerto Rico also has the lowest cervical cancer screening rates in the US, and higher HPV prevalence than on the mainland (34 vs. 27%; Dunne et al, 2007 ; Ortiz et al, 2013 ).…”