Global distribution of HPV types and implications for screening and vaccines.

The proportion of women infected with human papillomavims (HPV) varies greatly across populations. This study compared the distribution of different HIV types in representative samples of women from 11 countries, three in Latin America, three in Europe, four in Asia and one in Africa. A standardised

protocol was used for cervical specimen collection and HPV testing. The proportion of women with HPV was compared by study area and between pooled regions. Over 15,600 women without cervical abnormalities were included in the pooled analysis. Age-standardised prevalence of HPV varied nearly 20 times between populations, from 1.4% in Spain to 25.6% in Nigeria. Prevalence was highest in Africa, intermediate in Latin America and Asia and lowest in Europe. HPV 16 was the most common type found followed by nine other HPV types. Of the 1,429 HPV-positive women, 1,250 women had high-risk HPV types and 675 low-risk types. The proportion with multiple types ranged from 11.5% in Turin, Italy to 42.5% in Ho Chi Minh City, Vietnam. The authors argue that the heterogeneity in HPV-type distribution found in different populations should be taken into account when developing screening tests for the virus and for predicting the effectiveness of any vaccine in reducing the incidence of infection.

(1.) Clifford GM, Gallus S, Herrero R, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet 2005;366:991-98.

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