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Chung, Shin, Yoon, Roh, Seoung, Kim, and Kim: Prevalence and Genotype of Human Papillomavirus Infection and Risk of Cervical Dysplasia among Asymptomatic Korean Women
Original Article

Ann Clin Microbiol 2013;16(2):87-91.

Published online: 5 June 2013

DOI: https://doi.org/10.5145/ACM.2013.16.2.87

Prevalence and Genotype of Human Papillomavirus Infection and Risk of Cervical Dysplasia among Asymptomatic Korean Women

Soie Chung1, Sue Shin2, 3, Jong Hyun Yoon2, 3, Eun Youn Roh2, Sung Jun Seoung2, Gyoung Pyoung Kim2, Eui-Chong Kim3

1Department of Laboratory Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea

2Seoul National University Boramae Hospital, Seoul, Korea

3Seoul National University College of Medicine, Seoul, Korea

Correspondence: Sue Shin, Department of Laboratory Medicine, Seoul National University Boramae Hospital, 39 Boramae-gil, Dongjak-gu, Seoul 156-707, Korea. (Tel) 82-2-870-2602, (Fax) 82-2-870-2630, (E-mail) jeannie@snu.ac.kr

Received 9 November 20125 December 2012       Accepted 7 December 2012

Copyright © 2013 The Korean Society of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Background

The persistence of infection by high-risk human papillomavirus (HPV) may lead to cervical cancer. Recently, the American Society for Colposcopy and Cervical Pathology (ASCCP) announced that on-cogenic HPV screening and the PAP smear are the main methods of screening for cervical cancer. The goal of this study was to investigate the prevalence and genotyping of HPV, as well as the risk of cervical dysplasia.

Methods

HPV genotyping was conducted by a com-mercial chip assay. Cervical dysplasia was retro-spectively reviewed using electronic medical records. The study participants were grouped together according to cervical dysplasia status: ‘no dysplasia,’ ‘atypical squamous cells of undetermined significance (ASCUS),’ ‘low-grade squamous intraepithelial lesion (LSIL),’ and ‘high-grade squamous intraepithelial lesion (HSIL).’ The HPV prevalence and genotyping were analyzed according to the cervical dysplasia group.

Results

The overall prevalence of HPV was 17.6% (91 out of 518 patients). HPV-18 (2.3%), HPV-16 (2.1%), and HPV-58 (1.2%) were the three most fre-quent genotypes. The prevalence of HPV infection and the high-risk HPV positive rate was higher in the ASCUS, LSIL, and HSIL groups than in the no dysplasia group (P＜0.05).

Conclusion

In this study, basic data regarding the prevalence and distribution of HPV genotypes were obtained. Since HPV vaccination has been actively encouraged among Korean women, a change in the prevalence of HPV and cervical dysplasia is ex-pected in the future. This study provided basic data describing the prevalence of HPV and its genotypes in the pre-HPV vaccination era.

Keywords: Cervical dysplasia, HPV genotyping, Human papilloma virus

REFERENCES

1.Statistics Korea. Incidence and mortality of cancer in Korea. http://www.index.go.kr/egams/stts/jsp/potal/stts/PO_STTS_IdxMain.jsp?idx_cd=2770&bbs=INDX_001. [Online] (last visited on 24 October 2012).
2.Clifford GM., Smith JS., Aguado T., Franceschi S. Comparison of HPV type distribution in high-grade cervical lesions and cervical cancer: a meta-analysis. Br J Cancer. 2003. 89:101–5.
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3.Kim YT. Current status of cervical cancer and HPV infection in Korea. J Gynecol Oncol. 2009. 20:1–7.
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4.Bae JH., Lee SJ., Kim CJ., Hur SY., Park YG., Lee WC, et al. Human papillomavirus (HPV) type distribution in Korean women: a meta-analysis. J Microbiol Biotechnol. 2008. 18:788–94.
5.Rhee JE., Shin MY., Kim CM., Kee HY., Chung JK., Min SK, et al. Prevalence of human papillomavirus infection and genotype distribution among high-risk Korean women for prospecting the strategy of vaccine development. Virol J. 2010. 7:201.
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6.Shin HR., Franceschi S., Vaccarella S., Roh JW., Ju YH., Oh JK, et al. Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea. J Infect Dis. 2004. 190:468–76.
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7.Joo WD., Kim SH., Kim DY., Suh DS., Kim JH., Kim YM, et al. Prevalence of human papillomavirus infection in Korean women: risks of abnormal pap smear and cervical neoplasia. Korean J Gynecol Oncol Colposc. 2004. 15:309–16.
8.Kim KH., Yoon MS., Na YJ., Park CS., Oh MR., Moon WC. Development and evaluation of a highly sensitive human papillomavirus genotyping DNA chip. Gynecol Oncol. 2006. 100:38–43.
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9.Muñoz N., Bosch FX., de Sanjosé S., Herrero R., Castellsagué X., Shah KV, et al. International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classifi-cation of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003. 348:518–27.
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10.Clifford GM., Smith JS., Plummer M., Muñoz N., Franceschi S. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer. 2003. 88:63–73.
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Fig. 1.
Prevalence of human papilloma virus in each genotype. The number of HPV-infected patients in each genotype, including both single and multi-infection was divided by total number of patients (n=518). Abbreviation: HPV, human papilloma virus.
acm-16-87f1.tif
Table 1.
Prevalence of human papilloma virus infection according to genotype and patients age group
Age group HPV genotype group PAP smear
HPV any High-risk* HPV Low-risk HPV Other HPV Negative Normal ASCUS LSIL HSIL
20-39 (n=65) 18 (27.7) 8 (12.3) 0 (0.0) 10 (15.4) 47 (72.3) 63 (96.9) 2 (3.1) 0 (0.0) 0 (0.0)
40-49 (n=130) 22 (16.9) 13 (10.0) 1 (0.8) 8 (6.2) 108 (83.1) 122 (93.8) 3 (2.3) 3 (2.3) 2 (1.6)
50-59 (n=182) 29 (15.9) 9 (4.9) 1 (0.5) 19 (10.4) 153 (84.1) 176 (96.7) 3 (1.6) 2 (1.1) 1 (0.5)
≥60 (n=141) 22 (15.6) 14 (9.9) 1 (0.7) 7 (5.0) 119 (84.4) 135 (95.7) 3 (2.1) 2 (1.4) 1 (0.8)

The values are presented as number and percentage (%) in parentheses. *High-risk HPV genotype includes both single high-risk genotype infection and multiple genotype infection including any high-risk genotype. Abbreviations: HPV, human papilloma virus; ASCUS, atypical squamous cells of undetermined significance; LSIL, low-grade squamous intraepithelial lesion; HSIL, high-grade squamous intraepithelial lesion; PAP smear, papanicolaou smear.

Table 2.
The genotype-specific human papilloma virus prevalence stratified by PAP smear findings
Normal (n=496) ASCUS (n=11) LSIL (n=7) HSIL (n=4)
HPV any 78 (15.7) 5 (45.5) 4 (57.1) 4 (100.0)
HPV-16 10 (2.0)＊ 1 (9.1) 0 (0.0) 0 (0.0)
HPV-18 9 (1.8)＊ 1 (9.1) 1 (14.3) 1 (25.0)＊
HPV-31 1 (0.2) 0 (0.0) 0 (0.0) 1 (25.0)
HPV-33 3 (0.6)＊ 0 (0.0) 0 (0.0) 0 (0.0)
HPV-35 3 (0.6)＊ 0 (0.0) 0 (0.0) 1 (25.0)＊
HPV-39 3 (0.6)＊ 0 (0.0) 0 (0.0) 1 (25.0)＊
HPV-45 1 (0.2) 1 (9.1) 0 (0.0) 0 (0.0)
HPV-52 1 (0.2) 0 (0.0) 0 (0.0) 0 (0.0)
HPV-56 1 (0.2) 0 (0.0) 1 (14.3) 0 (0.0)
HPV-58 4 (0.8)＊ 0 (0.0) 1 (14.3) 1 (25.0)
HPV-59 1 (0.2) 0 (0.0) 0 (0.0) 0 (0.0)
HPV-66 3 (0.6) 0 (0.0) 0 (0.0) 1 (25.0)∗
HPV-68 2 (0.4)∗ 0 (0.0) 0 (0.0) 0 (0.0)
HPV-6 1 (0.2) 0 (0.0) 0 (0.0) 0 (0.0)
HPV-34 1 (0.2) 0 (0.0) 0 (0.0) 0 (0.0)
HPV-40 3 (0.6)＊ 0 (0.0) 0 (0.0) 0 (0.0)
HPV-43 2 (0.4)＊ 0 (0.0) 0 (0.0) 0 (0.0)
Other 41 (8.3) 2 (18.2) 1 (14.3) 0 (0.0)

The values are presented as number and percentage (%) in parentheses.

∗ ＊ Total of 11 cases were known as multiple genotype infections (HPV-16, HPV-43 coinfection; HPV-16, HPV-35, and HPV-68 coinfection; HPV-16, HPV-39, HPV-58, HPV-66, HPV-40, and HPV-43 coinfection; HPV-18, HPV-33 coinfection; HPV-18, HPV-35 coinfection; HPV-18, HPV-39 coinfection; HPV-18, HPV-40 coinfection; HPV-18, HPV-58 coinfection; HPV-18, HPV-68 coinfection; HPV-35, HPV-58 coinfection; HPV-35, HPV-66 coinfection).

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