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. 2022 Jun 15:28:1610424.
doi: 10.3389/pore.2022.1610424. eCollection 2022.

The Prevalence of High-Risk Human Papillomavirus in Hungary-A Geographically Representative, Cross-Sectional Study

András István Fogarasi  1 , Márta Benczik  1 , Ágota Moravcsik-Kornyicki  2 , Adrienn Kocsis  1 , Anikó Gyulai  3 , Zsigmond Kósa  2
Affiliations

The Prevalence of High-Risk Human Papillomavirus in Hungary-A Geographically Representative, Cross-Sectional Study

András István Fogarasi et al. Pathol Oncol Res. .

Abstract

Background: The estimated age-standardized incidence and mortality rates of cervical cancer in Hungary are substantially higher than the European average. In many countries, human papillomavirus (HPV) testing is the first-line method of cervical cancer screening in women >30 years. According to the European guidelines, evidence-based improvement of a national prevention strategy requires the monitoring of representative data. Methods: ThinPrep cervical samples were collected over a period of 8 months at 84 sampling sites, including 4,000 eligible samples with valid laboratory results from the screening target population of females aged 25-65 years, with addresses in the representative geographic area (19 counties and four major settlement types). Genotyping of high-risk HPV (hrHPV) was performed using the Confidence HPV-X (Neumann Diagnostics) and Linear Array HPV Genotyping (Roche) tests. Demographic data were collected using a questionnaire, enabling the analysis of hrHPV genotype distribution by age, geography, education, and HPV vaccination. Results: Overall, 446 samples were hrHPV-positive, showing a prevalence of 11.15% (9.73% age-representative), similar to the world average, higher than the European average, and lower than the Eastern-European average. After age standardization, no significant geographic differences were found, except for low hrHPV prevalence in villages (p = 0.036) and in those with elementary education (p = 0.013). Following genotypes 16 and 31, in order of frequency, certain non-vaccine hrHPV genotypes (HPV51, 66, 56) showed unexpectedly higher prevalence than international data. Conclusion: Our study provides the first geographically representative genotype-specific hrHPV prevalence baseline database in Hungary to support policy-making efforts. Significant correlations with demographic data have transferable conclusions.

Keywords: cancer screening; cervical cancer; cross-sectional studies; genotype; human papillomavirus infection; human papillomavirus vaccines; prevalence studies; rural population.

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Conflict of interest statement

Authors AIF, MB, and AK were employed by or contracted to the company SYNLAB Hungary Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Geographic representation of the prevalence of (A) all hrHPV, (B) HPV16, (C) HPV31, (D) HPV51 in the counties of Hungary.
FIGURE 2
FIGURE 2
Prevalence of hrHPV (%) by 5-year age groups among Hungarian women aged 25–65 years (significant differences from average at level p ≤ 0.05 are marked*).
FIGURE 3
FIGURE 3
Age distribution (%) of the sample set (n = 4,000) and the female population aged 25–65 years in Hungary (2018) (*significant differences at level p ≤ 0.05). Age in completed years.
FIGURE 4
FIGURE 4
Type-specific prevalence (%) of each hrHPV genotypes. Divided if singular infection or as part of a multiple hrHPV infection.
FIGURE 5
FIGURE 5
Geographic representation of rate of the three most frequent genotypes per county among Hungarian women aged 25–65 years.
FIGURE 6
FIGURE 6
hrHPV genotype prevalence (%) according to each 5-year age group.
See this image and copyright information in PMC

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