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      Prevalence of HPV infection among sexually active adolescents and young adults in Brazil: The POP-Brazil Study

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          Abstract

          For Brazil, there are no nationwide data on HPV prevalence against which the impact of the HPV immunization program can be measured in the future. Therefore, we aim to evaluate the prevalence of genital HPV infection among adolescents and young adults in Brazil. A cross-sectional, multicentric, nationwide survey was conducted between September 2016 and November 2017. Sexually active unvaccinated women and men aged 16 to 25 years old were recruited from 119 public primary care units, including all 26 state capitals and the Federal District. All participants answered a face-to-face interview and provided biological samples for genital HPV analysis. We used an automated DNA extraction method and HPV genotyping was performed using the Linear Array genotyping test (Roche). Of 7,694 participants, 53.6% (95% CI 51.4–55.8) were positive for any HPV type. The prevalence of high-risk HPV types was significantly higher in women (38.6% vs. 29.2%, P < 0·001). The HPV types included in the quadrivalent vaccine were detected in 1002 (14.8%) specimens, with a different pattern of HPV infection between sexes. Characteristics associated with overall HPV detection included female gender, self-declaration of race as brown/pardo, lower socioeconomic class, single or dating, current smoking and having 2 or more sex partners in the past year. We found a high prevalence of HPV, with significant differences between regions. Our data provide information that may be considered when developing HPV prevention policies and constitute a baseline against which the impact of the HPV immunization program in Brazil can be measured in future years.

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          The causal relation between human papillomavirus and cervical cancer.

          The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. The association is present in virtually all cervical cancer cases worldwide. It is the right time for medical societies and public health regulators to consider this evidence and to define its preventive and clinical implications. A comprehensive review of key studies and results is presented.
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            Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students.

            Incidence data on human papillomavirus (HPV) infection are limited, and risk factors for transmission are largely unknown. The authors followed 603 female university students in Washington State at 4-month intervals between 1990 and 2000. At each visit, a sexual and health questionnaire was completed and cervical and vulvovaginal samples were collected to detect HPV DNA. At 24 months, the cumulative incidence of first-time infection was 32.3% (95% confidence interval: 28.0, 37.1). Incidences calculated from time of new-partner acquisition were comparable for enrolled virgins and nonvirgins. Smoking, oral contraceptive use, and report of a new male sex partner--in particular, one known for less than 8 months before sex occurred or one reporting other partners--were predictive of incident infection. Always using male condoms with a new partner was not protective. Infection in virgins was rare, but any type of nonpenetrative sexual contact was associated with an increased risk. Detection of oral HPV was rare and was not associated with oral-penile contact. The data show that the incidence of HPV associated with acquisition of a new sex partner is high and that nonpenetrative sexual contact is a plausible route of transmission in virgins.
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              Prevalence of HPV After Introduction of the Vaccination Program in the United States.

              Since mid-2006, human papillomavirus (HPV) vaccination has been recommended for females aged 11 to 12 years and through 26 years if not previously vaccinated.
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                Author and article information

                Contributors
                elianawend@gmail.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                18 March 2020
                18 March 2020
                2020
                : 10
                : 4920
                Affiliations
                [1 ]ISNI 0000 0004 0398 2134, GRID grid.414856.a, Hospital Moinhos de Vento, ; Porto Alegre, Brazil
                [2 ]ISNI 0000 0004 0444 6202, GRID grid.412344.4, Graduate Program in Health Sciences and Graduate Program in Pediatrics, , Federal University of Health Sciences of Porto Alegre, ; Porto Alegre, Brazil
                [3 ]ISNI 0000 0004 0445 1036, GRID grid.488702.1, Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo (ICESP), ; São Paulo, Brazil
                [4 ]ISNI 0000 0001 2163 0069, GRID grid.416738.f, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, ; Atlanta, USA
                [5 ]ISNI 0000 0004 0602 9808, GRID grid.414596.b, National Immunization Program, Ministry of Health, ; Brasilia, Brazil
                [6 ]Tropical Medicine Foundation Heitor Vieira Dourado and Global Aids Healthcare Foundation, Manaus, Brazil
                [7 ]ISNI 0000 0001 2200 7498, GRID grid.8532.c, Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, ; Porto Alegre, Brazil
                [8 ]Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre, Rio Grande do Sul, Brazil
                [9 ]ISNI 0000 0004 0602 9808, GRID grid.414596.b, Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Ministry of Health, ; Brasília, DF Brazil
                Author information
                http://orcid.org/0000-0003-4074-2335
                http://orcid.org/0000-0002-2925-5635
                Article
                61582
                10.1038/s41598-020-61582-2
                7080737
                32188884
                6729e63c-bcc4-489a-bc29-cc29be019e37
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 13 November 2019
                : 13 February 2020
                Funding
                Funded by: Luisa Lina Villa is a member of the Board for HPV vaccines for Merck, Sharp & Dohme and a consultant for BD, Roche, and Qiagen for HPV tests.
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                Uncategorized
                epidemiology,translational research
                Uncategorized
                epidemiology, translational research

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