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Prevalence and Risk Factors of Human Papillomavirus Infection in 18–Year–Old Women

Baseline Report of a Prospective Study on Human Papillomavirus Vaccine

Igidbashian, Sarah MD; Boveri, Sara MSc; Bottari, Fabio ScB; Vidal Urbinati, Ailyn MD; Preti, Eleonora MD; Casadio, Chiara MD; Landoni, Fabio MD; Sideri, Mario MD; Sandri, Maria Teresa MD

Journal of Lower Genital Tract Disease: January 2017 - Volume 21 - Issue 1 - p 4–8
doi: 10.1097/LGT.0000000000000268
Original Research Articles: Cervix and HPV

Objectives Little is known about the epidemiology of human papillomavirus (HPV) in Italy before the age of 25. At the European Institute of Oncology, a prospective observational study on cervical HPV infection in 18-year-old women undergoing quadrivalent HPV vaccination is ongoing.

Methods At the first visit before vaccination, all the young women answered an epidemiological questionnaire, and then, the presence of high-risk HPV (hrHPV) was tested. Samples positive for hrHPV were genotyped. Liquid-based cytology was done only to women declaring not to be virgins. Any positivity at cytology or HPV testing was completed with colposcopy and eventually biopsies.

Results Seven hundred and thirty women were enrolled. Two hundred sixty-six women were virgins; 7 (2.6%) of these resulted positive to hrHPV: 1 had HPV16 and CP6108, whereas the other 6 resulted negative at genotyping. Of the 464 nonvirgins, 61 (13.1%) were HPV positive: 19 had HPV16, 4 were positive to HPV18 with other hrHPVs, 25 to other hrHPVs, 7 to low-risk HPV, whereas 13 resulted negative at genotyping. HPV positivity was significantly associated to both smoking and having more than 3 partners. Cervical cytology was negative in 433 cases (93.3%), ASC-US in 10 cases (2.2%), low-grade squamous intraepithelial lesion in 20 cases (4.3%), and ASC-H in 1 case (0.2%). No CIN2+ was identified.

Conclusions Overall, we found a low positivity to HPV in this population; however, the rate of HPV positivity was significantly related to smoking and sexual life. The cytology result low-grade squamous intraepithelial lesion was more frequent than in the screening population, whereas no CIN2+ was identified, confirming the indication to avoid screening at this age.

Low positivity rate of human papillomavirus (HPV) infection in 18-year-old women represents a target for catch-up programs, improving HPV vaccine coverage and encouraging healthy behaviors and HPV vaccination.

1Preventive Gynaecology Unit, 2Laboratory Medicine Unit, and 3Diagnostic Cytology Unit, European Institute of Oncology, Milan, Italy

Reprint requests to: Sarah Igidbashian, MD, Preventive Gynaecology Unit, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy. E-mail:

Conflict of interest statement: M.S. was consultant for Qiagen, Sanofi Pasteur, GSK, Roche Diagnostics, MTM, Innogenetics. The other authors have nothing to disclose.

IRB Status: This study was approved by the IEO ethics committee.

Copyright © 2017 by the American Society for Colposcopy and Cervical Pathology