Prevalence and genotype distribution of cervical human papillomavirus infection among female sex workers in Asia: a systematic literature review and meta-analysis

Abstract

Cervical human papillomavirus (HPV) infection is highly transmissible. Although there are many studies on HPV infection in general population of women globally, little attention has been paid to female sex workers (FSWs) in Asia. In this study, we used a meta-analytic approach to systematically analyse the literature to elucidate the prevalence and genotype distribution of cervical HPV infection among FSWs in Asia. Fourteen eligible studies were identified in five databases, and data including 4198 FSWs from nine Asian countries were aggregated. Crude estimates of cervical HPV prevalence among FSWs in this region ranged from 12.8% to 84.8%. FSWs had a nearly 10-fold risk of HPV infection than the general population of women. Stratified analysis showed that HPV prevalence was higher in East Asia than other subregions and in younger FSWs than older FSWs. HPV genotype distribution was statistically different between East Asia and South-east Asia. In East Asia, the most prevalent genotypes were HPV 16 (23.9%), 18 (11.0%), 58 (9.4%), 56 (6.3%) and 52 (5.3%), while they were HPV 52 (12.9%), 16 (8.5%), 58 (5.2%), 18 (5.0%) and 66 (4.9%) in South-east Asia. HPV 31, 33 and 35 were less frequently found in both subregions. HPV infection was substantial among FSWs in some Asian countries. More studies are necessary to illustrate the overall picture of HPV infection in this region.

Fig. 1.

Flow diagram of search strategy for published studies. ASP, Academic Source Premier; CNKI, China National Knowledge Information; FSW, female sex workers; HPV, human papillomavirus.

Fig. 2.

Prevalence of 10 most common high-risk human papillomavirus (HPV) genotypes by subregions.