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High frequency of genital human papillomavirus infections and related cervical dysplasia in adolescent girls in Belgium

Merckx, Mireillea; Benoy, Inad; Meys, Jorisc; Depuydt, Christophed; Temmerman, Marleena,b,e; Weyers, Stevena; Vanden Broeck, Davyb

European Journal of Cancer Prevention: July 2014 - Volume 23 - Issue 4 - p 288–293
doi: 10.1097/CEJ.0000000000000048
Research Paper: Gynecological Cancer

Human papillomavirus (HPV) infections are causally related to cervical cancer and a range of other diseases, both in adults and in minors. Information on the frequency of genital HPV infections in adolescents is sparse. The aim of this study was to gain insight into the genotype-specific distribution of HPV genotypes in patients younger than 18 years of age. This observational retrospective study included 4807 samples of patients presenting for opportunistic screening in Belgium between June 2006 and January 2012. For statistical analysis, only the first visits of patients were withheld, reducing the sample to 4180. Samples were collected in liquid-based cytology medium and analyzed using a series of genotype-specific real-time PCR reactions. Cytology was read with previous knowledge of HPV infection and scored using the Bethesda classification. The mean age was 16.9 years. Most youngsters had no complaints (88.4%), were using hormonal contraception (79.5%), and clinical examination did not show any abnormalities (96.0%). The overall HPV frequency was 15.7%, with the most frequently found types being HPV16 (16.7%), HPV51 (14.6%), HPV66 (10.4%), HPV31 (9.9%), and HPV39 (9.1%). More than one-third (39.0%) of the infected girls harbored an infection with at least two HPV genotypes. Cytological abnormalities were found in 8.2% of samples. L-SIL (4.2%) was most frequently observed, followed by ASC-US (3.6%), HSIL (0.3%), and ASC-H (0.1%). The severity of lesions worsened with increasing age. Our findings indicate that an aberrant HPV genotype profile can be found in adolescent girls; moreover, this group shows a high rate of cervical abnormalities.

aDepartment of Obstetrics and Gynaecology, Ghent University Hospital

bInternational Centre for Reproductive Health, Ghent University

cDepartment of Mathematical Modelling, Statistics and Bioinformatics, Faculty of Bioscience Engineering, Ghent University, Ghent

dDepartment of Molecular Diagnostics, Sonic Healthcare Benelux, AML/RIATOL, Antwerp, Belgium

eWorld Health Organization, Geneva, Switzerland

Correspondence to Mireille Merckx, MD, Department of Obstetrics and Gynaecology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium Tel: +32 9 332 35 64; fax: +32 9 332 38 67; e-mail:

Received May 27, 2013

Accepted October 8, 2013

© 2014 Lippincott Williams & Wilkins, Inc.