Introduction: The introduction of an HPV immunisation programme in England should result in a significant reduction in the prevalence of vaccine type infections in young women. Here we describe type-specific HPV prevalence in three samples of the young female population in England, prior to the beginning of mass immunisation in 2008. Methods: Residual vulva-vaginal swab samples from females aged under 25 years undergoing chlamydia testing as part of the National Chlamydia Screening Programme (NCSP) or Prevention of Pelvic Infection (POPI) trial were collected from sites across England, together with available demographic and sexual behaviour data. Residual samples were screened for HPV infection using the Hybrid Capture 2 (hc2) HPV DNA Test, including the high-risk (HR) and low-risk (LR) probes. Hc2 positive samples were genotyped using the Roche Linear Array (LA) HPV Genotyping Test. Results: A total of 3829 samples were included: 2369 from 16 to 24 year old NCSP participants, 275 from 13 to 15 year old NCSP participants and 1185 from 16 to 24 year old POPI participants. Variations in HPV prevalence between and within the different samples followed a pattern largely consistent with differences in sexual behaviour. The prevalence of total HR HPV infection, of HPV 16 and/or 18 (16/18) infection and of five HR HPV types closely related to HPV 16/18 (HPV 31, 33, 45, 52 or 58) amongst 16-24 year old NCSP participants was 35% (95% CI 33-37%), 18% (95% CI 16-19%), and 16% (95% CI 14-18%), respectively. Risk of HR HPV infection increased with age during the teen years and was higher in women who reported two or more sexual partners in the last year and in women with chlamydia infection. Approximately half of women with HPV 16/18 infection also had another non-vaccine HR HPV type present. Conclusions: Prior to HPV immunisation, there was a high prevalence of HPV infections in the lower genital tract of young, sexually active females in England. The overall, type-specific, and multiple infection prevalence closely reflected age and sexual activity. These data provide a baseline against which the early impact of HPV immunisation on the prevalence of HPV 16/18 and closely related types in young women can be measured, in order to inform immunisation and cervical screening policies.
Bibliographical noteFunding Information:
Contributors: KS and ONG were responsible for the study design and KS oversaw the conduct of the study. RHJ was responsible for sample collection, data management, data analysis and wrote the first draft of the manuscript. SB, NdS and MA were responsible for the HPV testing. CC, LC, MS, HM, VE, DF, TIR were responsible for sample collection from their laboratories. PO was responsible for the inclusion of POPI trial samples. All authors contributed to revising the manuscript and approved the final version of the manuscript. Conflict of interest statement: We declare that we have no conflict of interests. Funding: RHJ and NdS were funded by the Policy Research Programme in the Department of Health, UK (grant reference number 039/030 ). The HPV testing of samples was supported by a grant from GlaxoSmithKline (study number EPI-HPV-109903 ). The POPI trial was funded by The BUPA Foundation . The views expressed in the publication are those of the authors and not necessarily those of the Department of Health, or other funders.
Copyright 2012 Elsevier B.V., All rights reserved.
- Adolescent girls
- Human papillomavirus
- Young women