Age-specific human papillomavirus antibody and deoxyribonucleic acid prevalence: a global review

Abstract

Purpose: Global data on human papillomavirus (HPV) serological and deoxyribonucleic acid (DNA) prevalence are essential to optimize HPV prophylactic vaccination strategies.

Methods: We conducted a global review of age-specific HPV antibody and studies with both antibody and DNA prevalence for HPV-16, -18, -6, and -11.

Results: One hundred seventeen studies were included; participants' ages ranged from several hours to >90 years. HPV-16 seroprevalence was generally higher in Africa, Central and South America, and North America, more prevalent among women than among men, and peaked around ages 25-40 years. HPV-18 seroprevalence was generally lower than HPV-16 with a later age peak. Data were limited for HPV-6 and -11, both of which peaked at ages similar to HPV-18. Among 9-26-year-old females, HPV-16 seroprevalence ranged from 0%-31% in North America, 21%-30% in Africa, 0%-23% in Asia/Australia, 0%-33% in Europe, and 13%-43% in Central and South America. HPV-16/-18 DNA prevalence peaked 10-15 years before corresponding HPV-16/-18 antibody prevalence.

Conclusions: Females within the HPV vaccine-eligible age-group (9-26 years) had a range of dual HPV-16 DNA and serology negativity from 81%-87%, whereas 90%-98% were HPV-16 DNA negative. Serology and DNA data are lacking worldwide for females younger than age 15 years, the prime target group for vaccination.

Figure 1

Age-specific prevalence of HPV 16 DNA and antibodies against HPV 16 for studies with age-trend data, stratified by study area (16,19,29,57,58,62,116). All studies with age-trend data had only female participants.

Figure 2

Prevalence of different combinations of HPV 16 DNA and antibodies against HPV 16, stratified by study area. All studies with DNA and antibody data had only female participants.