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Population-Based Prevalence and Age Distribution of Human Papillomavirus Among Women in Santiago, Chile

¹ Escuela de Medicina, Pontificia Universidad Católica de Chile, ² Centro de Oncología Preventiva and ³ Escuela de Salud Pública, Universidad de Chile, Santiago, Chile; ⁴ Department of Pathology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; ⁵ IARC, Lyon, France; ⁶ Pan American Health Organization, Non-Communicable Diseases Program, Washington, District of Columbia; and ⁷ Proyecto Epidemiológico Guanacaste, Costa Rica

Requests for reprints: Catterina Ferreccio, Department of Public Health, School of Medicine, P Catholic University, Depto. de Salud Pública, Marcoleta, 434, Santiago, Santiago, 6510259, Chile. Phone: 562-354-3037; Fax: 011-56-2-6331840. E-mail: cferrec{at}med.puc.cl

More than 18 types of human papillomavirus (HPV) are associated with cervical cancer, the relative importance of the HPV types may vary in different populations.

Objective: To investigate the types of HPV, age distribution, and risk factors for HPV infection in women from Santiago, Chile.

Methods: We interviewed and obtained two cervical specimens from a population-based random sample of 1,038 sexually active women (age range, 15-69 years). Specimens were tested for the presence of HPV DNA using a GP5+/6+ primer-mediated PCR and for cervical cytologic abnormalities by Papanicolaou smears.

Results: 122 women tested positive for HPV DNA, 87 with high risk types (HR), and 35 with low risks (LR) only. Standardized prevalence of HPV DNA was 14.0% [95% confidence interval (95% CI), 11.5-16.4]. HR HPV by age showed a J reverse curve, whereas LR HPV showed a U curve, both statistically significant in comparison with no effect or with a linear effect. We found 34 HPV types (13 HR and 21 LR); HPV 16, 56, 31, 58, 59, 18, and 52 accounted for 75.4% of HR infections. Thirty-four (3.6%) women had cytologic lesions. Main risk factor for HPV and for cytologic abnormalities was number of lifetime sexual partners, odds ratios for 3 versus 1 were 2.8 (95% CI, 1.6-5.0) and 3.8 (95% CI, 1.3-11.4), respectively.

Conclusions: LR HPV presented a clear bimodal age pattern; HR HPV presented a J reverse curve. HPV prevalence was similar to that described in most Latin American countries.

Key Words: Human papillomavirus • Population-based • Prevalence • Age curve • Cytological cervical dysplasia • Risk factors • Nonparametric analysis • Epidemiological study

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