HPV 16 antibody prevalence in Jamaica and the United States reflects differences in cervical cancer rates

Human papillomavirus (HPV) is widely accepted as the primary etiologic agen t in the development of cervical cancer. DNA of a particular HPV type, HPV 16, is found in about half of tumors tested. Inconsistent with this causal relationship, however, population-based studies of HPV DNA prevalence have often failed to find high rates of anogenital HPV infection in countries wi th high cervical cancer rates. To examine this issue, we used serology to c ompare HPV 16 exposure in healthy volunteer blood donors in the United Stat es (n = 278) and similar subjects from a country with 3-fold higher cervica l cancer rates, Jamaica (n = 257). Jamaican sexually transmitted disease (S TD) patients (n = 831) were also studied to examine in detail the relation of HPV 16 antibodies with sexual history. Serology was conducted using an E LISA employing HPV 16 virus-like particles (VLPs). Age-adjusted seroprevale nce rates were greatest among male (29%) and female (42%) STD patients, int ermediate in male (19%) and female (24%) Jamaican blood donors and lowest a mong male (3%) and female (12%) U.S. blood donors. The higher seroprevalenc e in women was significant, and prevalence tended to increase with age. In multivariate logistic regression, controlling for age and gender, Jamaican blood donors were 4.2-fold (95% CI 2.4-7.2) and STD patients 8.1-fold (95% CI 5.0-13.2) more likely to have HPV 16 VLP antibodies than U.S. blood dono rs. Among STD patients, HPV 16 antibodies were associated with lifetime num ber of sex partners and years of sexual activity, as well as other factors. Our data suggest that HPV 16 VLP antibodies are strongly associated with s exual behavior. Moreover, exposure to HPV 16 appears to be much greater in Jamaica than in the United States, consistent with the high rate of cervica l cancer in Jamaica. Published 1999 Wiley-Liss, Inc.dagger.