Distribution of 37 mucosotropic HPV types in women with cytologically normal cervical smears: The age-related patterns for high-risk and low-risk types

Before guidelines can be set for the use of high-risk human papillomavirus (HR HPV) testing in cervical cancer screening and vaccine preparation, age- related prevalence of HR HPV types in cytologically normal smears has to be known. Therefore, in a cross-sectional study the prevalence of 37 differen t HPV genotypes and putatively unidentified HPV types was determined in 3,3 05 cytologically normal cervical smears from the general female population (15-69 years of age) using an HPV general primer GP5+/bioGP6+ mediated PCR assay. Subsequently, HPV-positive cervical smears were typed for 19 HR and 18 low-risk (LR) HPVs with an enzyme immunoassay using HPV type specific ol igoprobes in cocktails and individually, respectively. Overall, -HR and -LR HPV prevalences appeared to be of 4.6%, 3.3%, and 1.0%, respectively. Twen ty-six different HPV types were detected in the 152 HPV-positive samples, t he most prevalent types being HPV 16, 31, and 18, With regard to age, a pea k prevalence of 19.6% for all HPVs was found in women 25-29 years of age, w hich declined to a mean of 4.3% in women over 30 years. With regard cytolog ically normal cervical smears (n = 3,011) of women participating in the pop ulation-based screening program in the Netherlands (30 to 60 years), all HR HPVs showed decreased occurrence with increasing age, whereas the prevalen ce of LR HPV types remained constant. We suggest that screening for abnorma l cytology implies screening for HR HPV infections and the subsequent treat ment results in a decline of HR HPV prevalence in contrast to LR HPV preval ence during the years of screening. Int. J. Cancer 87:221-227, 2000. (C) 20 00 Wiley-Liss, Inc.