Type-Specific HPV Prevalence in Cervical Cancer and High-Grade Lesions in Latin America and the Caribbean: Systematic Review and Meta-Analysis

Abstract

BackgroundCervical cancer is a major public health problem in Latin America and the Caribbean (LA&C), showing some of the highest incidence and mortality rates worldwide. Information on HPV type distribution in high-grade cervical lesions (HSIL) and invasive cervical cancer (ICC) is crucial to predict the future impact of HPV16/18 vaccines and screening programmes, and to establish an appropriate post-vaccinal virologic surveillance. The aim was to assess the prevalence of HPV types in HSIL and ICC in studies in LA&C.Methods and FindingsWe performed a systematic review, following the MOOSE guidelines for systematic reviews of observational studies, and the PRISMA statement for reporting systematic reviews and meta-analyses. Inclusion criteria were at least ten cases of HSIL/ICC, and HPV-type elicitation. The search, without language restrictions, was performed in MEDLINE, Cochrane Library, EMBASE, LILACS from inception date to December 2009, proceedings, reference lists and consulting experts. A meta-analysis was performed using arc-sine transformations to stabilize the variance of simple proportions. Seventy-nine studies from 18 countries were identified, including 2446 cases of HSIL and 5540 of ICC. Overall, 46.5% of HSIL cases harbored HPV 16 and 8.9% HPV18; in ICC, 53.2% of cases harbored HPV 16 and13.2% HPV 18. The next five most common types, in decreasing frequency, were HPV 31, 58, 33, 45, and 52.Study's limitations comprise the cross-sectional design of most included studies and their inherent risk of bias, the lack of representativeness, and variations in the HPV type-specific sensitivity of different PCR protocols.ConclusionsThis study is the broadest summary of HPV type distribution in HSIL and ICC in LA&C to date. These data are essential for local decision makers regarding HPV screening and vaccination policies. Continued HPV surveillance would be useful, to assess the potential for changing type-specific HPV prevalence in the post-vaccination era in Latin America.

Frequency and Type-distribution of Human Papillomavirus from Paraffin-embedded Blocks of High Grade Cervical Intraepithelial Neoplasia Lesions in Thailand

“…In overall summarized of our study found that the HPV prevalence ratio in HSIL was not different from the other in analogous previous studies (Bhatla et al, 2008;Ciapponi et al, 2011;Correnti et al, 2011;Mateos et al, 2011), although the multiple HPV infection radio was higher than the others. The most six common HPV types in this study were HPV 16, 52, 18, 51, 31 and 33.…”

“…From a systematic review of seventy-nine studies of type specific HPV prevalence in cervical cancer and high grade lesions from 18 countries in Latin America and the Caribbean (Ciapponi et al, 2011), the results showed 82.5% of HSIL cases harbored in HR-HPV, in which 16.8% (12.9-21.2) was multiple type infection, 45.5% was infected with HPV 16 and 8.9% was HPV 18. The next five most common types were HPV 31, 58, 33, 45 and 52.…”

“…The prevalent of high risk HPV in high-grade lesion is about 84.9% (84.1-85.7) (Dowhanick et al, 1995) and multiple infection of HPV is found about 20%-50% (Bhata et al, 2008;Ciapponi et al, 2011;Correnti et al, 2011). Currently, there are a lot of methods for the HPV detection and typing.…”

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

“…Neste estudo o HPV 16 também foi o mais prevalente nas mulheres positivas e negativas para o HIV, que tiveram ou não NIC. Infecções cervicais por múltiplos tipos de HPV de alto risco estão associadas com aumento do risco de lesões de alto grau em mulheres com citologia oncótica alterada 38 . As mulheres positivas para o HIV apresentaram, neste estudo, 6,3% de infecções por múltiplos tipos de HPV, porcentagem menor do que os 64,8% encontrados em outros estudos 20,34 .…”

Progreso en el logro de los Objetivos de Desarrollo del Milenio: la mortalidad por cáncer de cérvix desciende en Colombia

“…En 2008 causó 7,6 millones de defunciones, de las cuales aproximadamente un 70% se produjeron en países de ingresos bajos y medios [1]. El cáncer de cuello uterino es uno de los más frecuentes tanto en incidencia como en mortalidad, contribuye con el 9,8% de todos los cánceres femeninos que afectan a mujeres relativamente jóvenes, y constituye la principal causa de años de vida potencialmente perdidos por cáncer en paí-ses en desarrollo [2,3].…”