Fiona Van der Klis (Netherlands)
RIVM CibPresenter of 1 Presentation
HIGH SEROPREVALENCE OF MULTIPLE HIGH-RISK HUMAN PAPILLOMAVIRUS TYPES AMONG THE GENERAL POPULATION OF BONAIRE, ST. EUSTATIUS AND SABA, CARIBBEAN NETHERLANDS (ID 762)
Abstract
Introduction
Incidence of cervical cancer and mortality rates differs geographically, being highest in African and Caribbean countries. Seroepidemiological data is an important tool to provide information on lifetime cumulative human papillomavirus (HPV) exposure and past infection, but has not been available yet for Caribbean Netherlands (CN) – comprising the islands Bonaire, St. Eustatius and Saba. Hence, a cross-sectional population-based serosurveillance study was performed in 2017, and here we report on seven high-risk (hr-)HPV types (HPV16, 18, 31, 33, 45, 52 and 58).
Methods
Participants (n=1,823, aged 3 months-90 years, randomly selected from the population registry) donated a blood sample and completed a health-related questionnaire. Hr-HPV-specific IgG-antibodies were tested in a VLP-based multiplex-immunoassay. Vaccinated individuals (n=102) (quadrivalent vaccine was introduced on St. Eustatius and Saba in 2013, and bivalent vaccine on all islands in 2015) were excluded from seroprevalence estimations. Risk factors for HPV seropositivity were analysed using GEE and restricted to those unvaccinated, >14 years of age and ever had sex (n=1,080).
Results
Overall HPV seroprevalence was 29.7% (95% CI 26.9-32.4). From 15 years of age, overall seroprevalence was 34.0% (95% CI 30.8-37.3), with over half of them being seropositive for ≥ 2 hr-HPV types. HPV16 and HPV52 were most prevalent (both 13.1%) and HPV33 (8.9%) least. Seroprevalence was highest on St. Eustatius (38.4%), followed by Bonaire (33.4%) and Saba (33.1%), and substantially higher in women (51.4%) than men (18.1%, p=<0.0001). In multivariate analyses, age group 25-34 years, women, increasing lifetime sexual partners and history of reported STI were significantly associated with HPV seropositivity.
Conclusions
In accordance with the Caribbean region, seroprevalence of multiple hr-HPV types is high in CN, especially among women. In addition to the recently introduced vaccination, introduction of HPV screening in women in CN could therefore have great impact.