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Prevalence of Human Papillomavirus Infection Among Women in Concordia, Argentina:: A Population-Based Study

Matos, Elena PhD*; Loria, Dora PhD*; Amestoy, Gustavo M. MD, PhD† a; Herrera, Lily MD; Prince, Miguel A. MD; Moreno, Juan MD; Krunfly, Cristina MD; van den Brule, A. J. C. PhD§; Meijer, Chris J. L. M. MD§; Muñoz, Nubia MD, MPH; Herrero, Rolando MD, PhDProyecto Concordia Collaborative Group

Sexually Transmitted Diseases: August 2003 - Volume 30 - Issue 8 - p 593-599
doi: 10.1097/01.OLQ.0000085181.25063.6C
Article

Background Preparing for HPV vaccine programs, studies are needed of HPV infection in different populations.

Goal The goal was to evaluate HPV prevalence and determinants in Concordia, Argentina.

Study Design A stratified random sample of 1786 households was obtained. Consenting women aged ≥15 years were interviewed and underwent examination, including colposcopy. Cells were collected for a Papanicolaou smear and HPV DNA testing with GP5+/6+ primer-mediated PCR-EIA.

Results PCR was performed on specimens from 987 women. Prevalence among women reporting no previous sexual activity was 3%, and among sexually active women it was 17.7%, peaking at <25 years of age and decreasing to a minimum at ≥65 years of age. However, low-risk types had similar prevalence (≈5%) in all age groups. HPV16 (4.0%), HPV35 (2.6%), and other high-risk types were the most common. Almost half of infections were multiple. Younger women initiated sexual activity earlier and had more partners. The main determinants of HPV detection were lifetime number of sex partners and vaginal discharge.

Conclusion A clear pattern of decreasing prevalence of HPV with age was observed. This could be explained by development of immunity against specific types over time or related to a cohort effect associated with a recent spread of HPV in this population after recent changes in sexual behavior.

The prevalence of HPV infection was 3% among virgins and 17% among sexually active women in Concordia. HPV 16 was the most common type. Prevalence decreases with age, and risk factors include sex partners and vaginal discharge.

*Instituto Roffo, University of Buenos Aires and CONICET, and CEMIC and Austral University Hospital, Buenos Aires, Argentina; Hospital Felipe Heras, Concordia, Entre Ríos, Argentina; §Free University Hospital, Amsterdam, The Netherlands; and IARC, Lyon, France and Proyecto Epidemiológico Guanacaste, San José, Costa Rica

aDeceased.

The authors acknowledge the collaboration of the members of the Proyecto Concordia Collaborative Group: N. Converti, E. Fainman, G. Garcia, S. Joannas, A. Kobal, M. S. Lasco, P. Ledo, A. Mas, E. Oppel, M. A. Ragone, H. Rios, M. A. Ripoll, F. Rivas, J. Rivas, G. Rivero, G. Rodriquez, C. Scattone, and R. Tolomei (gynecologists); A. M. Rodriguez (media campaign); M. F. Taborda, Y. Lorenzo, L. Barrios, and M. Pellandino (interviewers); C. Quiroz (secretary in Concordia); and M. Vilensky (technical support in Buenos Aires). This project was also made possible with the help of the INDEC Buenos Aires, INDEC Parana, Municipality of Concordia, LALCEC Concordia.

Grant support: Alberto J. Roemmers Foundation, Argentina (grant 1998); Arges Cassara Pharmaceutical Laboratory, Argentina; and IARC Collaborative Research Agreement FIS/98/03.

Reprint requests: Dr. Rolando Herrero, Proyecto Epidemiologico Guanacaste, Costa Rican Foundation for Health Sciences, Apartado 125-6151, Santa Ana 2000, Costa Rica. E-mail: rherrero@amnet.co.cr

Received October 4, 2002,

revised February 13, 2003, and accepted February 18, 2003.

© Copyright 2003 American Sexually Transmitted Diseases Association