Wiener klinische Wochenschrift

, 120:666 | Cite as

Prevalence of human papillomavirus types 6, 11, 16 and 18 in young Austrian women – baseline data of a phase III vaccine trial

  • Lucia Six
  • Sepp Leodolter
  • Heather L. Sings
  • Eliav Barr
  • Richard Haupt
  • Elmar A. Joura
Original Article

Summary

INTRODUCTION: Cervical cancer is the second most common cancer among women worldwide. In the absence of changing risk or intervention, it is projected that in comparison with 2002 there will be a 40% increase in the number of new cases of cervical cancer by 2020. HPV types 16 and 18 cause 70% of cervical cancers worldwide, 50% of high-grade cervical intraepithelial neoplasias and 25% of low-grade neoplasias. HPV types 6 and 11 are the causative agent of > 90% of genital warts. The aim of this study was to assess the baseline prevalence of infection with HPV 6, 11, 16 and 18 in young Austrian women. METHODS: Austrian females aged 16–24 (n = 123) were enrolled in a double-blind, placebo-controlled, randomized phase III trial of a quadrivalent HPV (types 6, 11, 16, 18) vaccine (FUTURE I, ClinicalTrials.gov number NCT00092521). Healthy women who were not pregnant and had no prior history of genital warts or abnormal results on cervical cytologic testing and had fewer than five lifetime sex partners were eligible for enrollment. The study sub-population was recruited primarily from university settings. RESULTS: Analysis of the sexual history of the Austrian subjects showed that 92.7% (114/123) were non-virgins and 46.3% were current smokers. At enrollment, 15 (13.5%) had positive serological or PCR tests for HPV 6, 11, 16 or 18. Serologically, 14 (12.3%) of women were positive to HPV 6, 11, 16 or 18: of these, 13 (11.4%) were positive for HPV 16, four (3.5%) were positive for HPV 18, and one (0.9%) for HPV 6. By PCR all were negative for HPV 6 and 11, whereas seven (6.1%) were positive for HPV 16 and one (0.9%) for HPV 18. Abnormal cytology was observed in 12 (10.3%) women. DISCUSSION: Although the prevalence of vaccine HPV types among young Austrian women with fewer than five lifetime sexual partners was lower than in international data, we observed a high prevalence of abnormal cytology and smoking. These data suggest that a substantial number of Austrian women are at risk for HPV-related disease.

Keywords

HPV infection Prevalence Prophylactic HPV vaccination Abnormal cervical cytology HPV-related anogenital disease 

Die Prävalenz der Infektion durch Humane Papilloma Viren (HPV) 6, 11, 16, 18 bei Frauen zwischen 16 und 24 Jahren in Österreich – Österreichische Daten einer Phase III Studie zur Testung eines quadrivalenten Impfstoffes gegen HPV 6, 11, 16, 18

Zusammenfassung

EINLEITUNG: Das Zervixkarzinom ist die weltweit zweit häufigste Krebserkrankung bei Frauen. Bei gleich bleibender Tendenz der letzten Jahre und unveränderter therapeutischer Intervention ist bis 2020 eine Zunahme der Neuerkrankungen um 40% gegenüber 2002 zu erwarten. HPV 16 und 18 verursachen weltweit 70% aller Zervixkarzinome, 50% der höhergradigen und 25% der niedriggradigen zervikalen Neoplasien. HPV 6 und 11 sind in über 90% der Fälle die Ursache von Genitalwarzen. Das Ziel dieser Analyse ist die Ermittlung der Prävalenz der HPV 6, 11, 16, 18 Infektion junger Frauen in Österreich. METHODIK: Insgesamt wurden 123 Frauen im Alter von 16 bis 24 Jahren in eine Doppelblind-, plazebo-kontrollierte, Phase III Impfstudie randomisiert. Es wurde ein Vierfachimpfstoff gegen die HPV Typen 6, 11, 16 und 18 getestet (FUTURE I, ClinicalTrials.gov number NCT00092521). Eingeschlossen wurden nicht schwangere, gesunde Frauen, welche keine Genitalwarzen oder Auffälligkeiten des zytologischen Zervixabstrichs in der Anamnese hatten. Die Teilnehmerinnen durften nicht mehr als vier Sexualpartner gehabt haben. ERGEBNISSE: Die Anamnese zeigte, dass 114 (92,7%) Teilnehmerinnen ihr Sexualleben aufgenommen hatten. 46,3% der Probandinnen waren Raucherinnen. Bei Studieneinschluss waren 15 (13,5%) Teilnehmerinnen HPV 6, 11, 16 oder 18 positiv, entweder serologisch oder bei der Abstrichanalyse durch Polymerase Kettenreaktion (PCR). PCR-Ergebnisse: Eine Infektion mit HPV 6 und 11 wurde bei keiner Probandin gefunden, während 7 (6,1%) HPV 16 und 1 (0,9%) HPV 18 positiv waren. Ergebnisse der Serologie: 14 (12,3%) Frauen waren HPV 6, 11, 16 oder 18 positiv, 13 (11,4%) waren HPV 16 positiv, 4 (3,5%) HPV 18 positiv und 1 (0,9%) war HPV 6 positiv. Zytologische Auffälligkeiten des Zervixabstrichs fanden sich bei 12 (10,3%) Frauen. DISKUSSION: Verglichen mit internationalen Daten zeigen die österreichischen Ergebnisse eine niedrige HPV Prävalenz bei jungen Frauen, die weniger als fünf Sexualpartnern hatten. Dennoch wurde eine hohe Prävalenz an zytologischen Auffälligkeiten festgestellt und ein hoher Anteil der Teilnehmerinnen waren Raucherinnen. Die erhobenen Daten lassen darauf schließen, dass ein bedeutender Anteil von österreichischen Frauen ein hohes Risiko für HPV-assoziierte Erkrankungen hat.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Lucia Six
    • 1
  • Sepp Leodolter
    • 1
  • Heather L. Sings
    • 2
  • Eliav Barr
    • 2
  • Richard Haupt
    • 2
  • Elmar A. Joura
    • 1
  1. 1.Department of Gynecology and Obstetrics, Women's Health ClinicMedical University of ViennaViennaAustria
  2. 2.Merck Research LaboratoriesWest PointUSA

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