engleski

High relative prevalence of low-risk/high-risk hpv co-infection in croatian women older than 65 years of age and its public health implications

The specific population prevalence of low-risk and high-risk HPV among women in Croatia older than 65 years of age and its impact on their health is still unknown. Nowadays significantly more women are aging with their uterus intact and hence remain vulnerable to cervical HPV disease. In addition, many older women are sexually active and engage in other behaviours (such as smoking) that are recognized risk factors for genital tract HPV . Our aim was to determine the prevalence of low-risk (LR) and high-risk (HR) HPV infection (as well as co-infection with both types) in elderly female population primarily from Zagreb region (Croatia) as a first step towards adequate public health awareness of this issue. The study involved a total of 102 non-hysterectomised women older than 65 (from 65 to 80 years of age) and tested in the outpatient clinic during a 5-year period. HPV testing was performed from the cervical swabs using the Hybrid Capture 2 (hc2) HPV DNA Test (Qiagen Corporation, Gaithersburg, MD, USA) according to the manufacturer’s protocol. Total HPV prevalence in our study population was 28.43%, without any statistically significant yearly variations. Among HPV positive women, 10.34% were positive for only LR HPV, 31.04% were positive for only HR HPV, whereas 58.62% were positive for both LR and HR HPV. Such large percentage of HPV-positive elderly women harbouring co-infections with both LR and HR HPV (compared to those infected by only one of the risk types) represents a novel and important finding. It was previously shown in a cohort of younger women from Zagreb that such co-infection pattern can have a compounding effect on the occurrence of cytological changes leading to cervical dysplasia and potential cervical cancer in the long run. Although thus far it was deemed reasonable to use only a Pap smear to screen women older than 65 for cervical cancer because of their low risk, it seems somewhat premature to assume that HPV transmission in this age group will not follow an upward trend similar to some other sexually transmitted infections. Therefore a transition from savings-driven to patient-care-driven screening guidelines should be advocated

Human papillomavirus, HPV prevalence, women older than 65

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