Prevalence of Human Papillomavirus and Genotype Distribution in Pregnant and Non-Pregnant Women in China

Dandan Luo; Meilian Peng; Xizhen Wei; Diling Pan; Huifeng Xue; Yuying Xu; Binhua Dong

doi:10.2147/RMHP.S288838

Prevalence of Human Papillomavirus and Genotype Distribution in Pregnant and Non-Pregnant Women in China

Risk Manag Healthc Policy. 2021 Jul 28:14:3147-3157. doi: 10.2147/RMHP.S288838. eCollection 2021.

Authors

Dandan Luo¹, Meilian Peng², Xizhen Wei¹, Diling Pan³, Huifeng Xue⁴, Yuying Xu¹, Binhua Dong²

Affiliations

¹ Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
² Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
³ Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
⁴ Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

Abstract

Purpose: The status of human papillomavirus (HPV) infection in pregnant and non-pregnant women in China remains unclear. This study aimed to compare the prevalence and genotype distributions of HPV between pregnant and non-pregnant women in China.

Patients and methods: A case-control study was conducted of pregnant women during the second trimester and age-matched non-pregnant women attending the Fujian Maternity and Child Health Hospital between January 1, 2017 and December 31, 2018. Participants underwent cervical cytology testing and HPV genotyping. The genotyping test was able to identify 14 high-risk HPV (HR-HPV), four possible HR-HPV, and five low-risk HPV (LR-HPV) types. Further colposcopy and a cervical biopsy were performed if indicated. The primary outcomes were HPV prevalence and genotype distribution.

Results: In total, 1077 pregnant and 1077 non-pregnant women were enrolled. Compared with non-pregnant women, pregnant women had a higher prevalence of HPV (24.2% vs 14.8%), HR-HPV (20.2% vs 11.7%), and LR-HPV (8% vs 4.5%) infection. In pregnant women, the most prevalent HPV genotypes were HPV-52 (6.0%), -16 (3.5%), -58 (2.6%), -53 (2.5%), and -51 (2.5%), while in non-pregnant women the most prevalent genotypes were HPV-52 (3.6%), -81 (1.9%), -51 (1.8%), -68 (1.4%), and -16 (1.3%). In women aged ≥35 years, HR-HPV (P=0.002) and LR-HPV (P=0.001) prevalence were significantly higher in pregnant women. However, in women aged <35 years, only HR-HPV prevalence was higher in pregnant women. Pregnant and non-pregnant women with HPV-16 and HPV-58 infection had a high prevalence of high-grade squamous intra-epithelial lesions (HSIL) (HPV-16: P<0.001 and P=0.005, HPV-58: P=0.043 and P=0.005); but with other HR-HPV genotypes, only non-pregnant women had an increased HSIL prevalence.

Conclusion: In China, the HPV prevalence is higher in pregnant women than that in non-pregnant women and is also age- and genotype-dependent. HPV-infected pregnant women aged ≥35 years and those with HPV-16 should be closely monitored to enable rapid clinical intervention.

Keywords: China; cervical cytology; genotype; human papillomavirus; pregnant; squamous intraepithelial lesions.

Grants and funding

This study was funded by the Fujian Provincial Natural Science Foundation of China (grant no. 2017J01232); Fujian Maternity and Child Health Hospital Natural Science Foundation (grant no. YCXM18–18); Fujian Provincial Health and Education Joint Project (grant no. 2019-WJ-05) and Fujian Provincial Maternity and Child Health Hospital Fund (grant no. 13-27); Fujian Provincial Health Commission Innovation Project (grant no. 2019-CX-7).