Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, 99138, Cyprus.
Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Eastern Mediterranean University, Famagusta, Cyprus.
BMC Womens Health. 2023 Jun 3;23(1):297. doi: 10.1186/s12905-023-02451-8.
Human papillomavirus (HPV) is the most common sexually transmitted pathogen both in men and women. Accumulating epidemiological evidence supports a strong association between HPV infection and cancer of the cervix, vulva, vagina, anus, and penis. Currently, data on the HPV prevalence and genotyping is lacking in Northern Cyprus, a region in which HPV vaccination is not freely accessible via the national immunization program. The aim of this study was to evaluate the HPV type-specific prevalence in women with and without cytological abnormalities living in Northern Cyprus.
A total of 885 women who presented to the Department of Gynecology and Obstetrics Clinic between January 2011 and December 2022 were included in the study. Samples were collected for cytology. Cervical specimens were investigated for the presence of HPV-DNA and genotyping of HPV was performed using real-time polymerase chain reaction (rtPCR). Cytological examination was interpreted according to the Bethesda system.
Among all patients, overall high-risk HPV DNA prevalence was 44.3%. HPV-16 and HPV-18 positivity was found in 10.4% and 3.7% of women respectively, while other high-risk HPV (OHR-HPV) was the most frequent type of HPV (30.2%). The highest frequency of HPV infection was observed in the 30-55 age group (51.0%), followed by the < 30 age group (45.7%). Co-infection with two or more HPV types was observed in 17.0% of all positive samples, in which the prevalence of HPV-16 + HPV-18 was 2.3%, HPV-16 + OHR-HPV and HPV-18 + OHR-HPV was 12.0% and 5.1%, respectively. Among the screened patients, 37.5% had abnormal and 62.5% had normal cytology results. HR-HPV positivity was 65.7% and 34.0% in patients with abnormal and normal cytology. The highest incidence of HRC-HPV was OHR-HPV types (44.7%) in positive cytology cases. Among women with a cytology result of ASCUS, L-SIL, H-SIL and unspecified dysplasia, 52.1%, 67.6%, 97.5% and 75.6% were respectively infected with HR-HPV.
The present study provides the latest epidemiological data related to HPV prevalence and genotype distribution among women living in Northern Cyprus. Considering the unavailability of free vaccination in the community, it is imperative to implement local HPV screening programs and provide guidelines on HPV prevention and measures during early school education.
人乳头瘤病毒（HPV）是男性和女性中最常见的性传播病原体。越来越多的流行病学证据表明，HPV 感染与宫颈癌、外阴癌、阴道癌、肛门癌和阴茎癌之间存在很强的关联。目前，北塞浦路斯地区缺乏 HPV 流行率和基因型的数据，而 HPV 疫苗接种在该地区并未通过国家免疫计划免费提供。本研究的目的是评估在北塞浦路斯居住的有和无细胞学异常的女性中 HPV 型特异性流行率。
本研究共纳入 2011 年 1 月至 2022 年 12 月期间在妇产科诊所就诊的 885 名女性。采集样本进行细胞学检查。采用实时聚合酶链反应（rtPCR）检测宫颈标本 HPV-DNA，并对 HPV 进行基因分型。细胞学检查结果根据巴氏系统进行解释。
所有患者中，高危型 HPV DNA 总阳性率为 44.3%。HPV-16 和 HPV-18 的阳性率分别为 10.4%和 3.7%，而其他高危型 HPV（OHR-HPV）是最常见的 HPV 类型（30.2%）。HPV 感染率最高的年龄组为 30-55 岁（51.0%），其次为<30 岁（45.7%）。所有阳性样本中观察到 17.0%存在两种或两种以上 HPV 型别的合并感染，其中 HPV-16+HPV-18 的发生率为 2.3%，HPV-16+OHR-HPV 和 HPV-18+OHR-HPV 的发生率分别为 12.0%和 5.1%。在所筛查的患者中，37.5%的细胞学结果异常，62.5%的细胞学结果正常。异常细胞学结果患者的 HR-HPV 阳性率为 65.7%，正常细胞学结果患者的 HR-HPV 阳性率为 34.0%。阳性细胞学结果中 HR-HPV 感染最高的是 OHR-HPV 型（44.7%）。在 ASCUS、L-SIL、H-SIL 和未特指的不典型增生的细胞学结果患者中，分别有 52.1%、67.6%、97.5%和 75.6%感染了 HR-HPV。
本研究提供了北塞浦路斯地区女性 HPV 流行率和基因型分布的最新流行病学数据。考虑到社区内免费疫苗接种的不可用性，有必要实施当地 HPV 筛查计划，并在早期学校教育中提供 HPV 预防和措施指南。
