HPV prevalence underestimated
A timely study from the USA reinforces the recent recommendation of the US Advisory Committee on Immunization Practices that the new human papillomavirus (HPV) vaccine should be offered to all girls aged 11 and 12.
The study looked at a representative sample of 1,921 girls and women aged 14 to 59. Self-collected vaginal swabs were analysed for the presence of HPV.
The overall prevalence of HPV in the study population was 26.8% (95% CI, 23.3%-30.9%). The peak prevalence, found in women aged 20-24 years, was more than 44% (95% CI, 36.3%-55.3%). Disturbingly, in girls aged 14-19 the prevalence of HPV was 24.5%. The study found a significant increase in HPV prevalence with each year of age from 14 to 24 years. Age younger than 25 years was found to be independently associated with HPV detection.
These figures are reported as being much higher than estimates of HPV carriage.
The study also found that living below the poverty index, low levels of education, being unmarried and increasing numbers of recent or lifetime sexual partners were all significantly associated with HPV.
Social factors have an important part to play in determining prevalence, and transferring this data to the UK has dangers. However, given that the rate of teenage pregnancy in the UK is higher than in the USA, carriage of HPV in young people is likely to be even higher here. The sooner we can start immunising girls the better.
Dunne EF, Unger ER, Sternberg M et al. Prevalence of HPV infection among females in the United States. JAMA 2007;297:813-819reviewerreviewer Reviewer
Dr Peter Saul
GP, Wrexham and hospital practitioner in paediatrics (asthma and allergy)