Prevalence of Cervical High-risk Human Papilloma Viral Infection in Pregnant Women at HRH Maha Chakri Sirindhorn Medical Center, Thailand
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Abstract
Objectives: To determine the prevalence of high-risk human papilloma viral (HR-HPV) infection and the factors associated with HR-HPV infection among Thai pregnant women.
Materials and Methods: This cross-sectional study was conducted at the HRH Princess Maha Chakri Sirindhorn Medical Center from May 1, 2022 to January 31, 2023. The data were collected through primary HPV testing, liquid-based cytology (LBC), and a questionnaire.
Results: Overall, 188 pregnant women participated in the study. The mean age was 28.91 years old. The prevalence of HPV infection was 12.7% (24/188), and the two most common types were HPV 52 (6/188, 3.1%) and HPV 16 (5/188, 2.66%). No case of HPV type 18 infection was detected. Abnormal cervical cytology smears were detected in 21 samples (11.17%). The women who had multiple partners had a significantly higher risk of HR-HPV infection compared to the group who had only a single partner (p < 0.05).
Conclusion: The prevalence of HR-HPV infection during pregnancy in Thai women was 12.7%. Having multiple partners was found to be the greatest risk factor in this study. Primary HPV testing at a prenatal visit may be an option to improve screening coverage and could be considered in future cervical cancer screening programs.
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References
Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human papillomavirus and related diseases in the world. Summary Report 10 March 2023.
Bruni L, Serrano B, Roura E, Alemany L, Cowan M, Herrero R, et al. Cervical cancer screening programs and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health 2022;10:e1115-e27.
Ploysawang P, Rojanamatin J, Prapakorn S, Jamsri P, Pangmuang P, Seeda K, et al. National cervical cancer screening in Thailand. Asian Pac J Cancer Prev 2021;22:25-30.
Fontham ETH, Wolf AMD, Church TR, Etzioni R, Flowers CR, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin 2020;70:321-46.
Castle PE, Stoler MH, Wright TC, Jr., Sharma A, Wright TL, Behrens CM. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol 2011;12:880-90.
Termrungruanglert W, Khemapech N, Tantitamit T, Sangrajrang S, Havanond P, Laowahutanont P. Cost-effectiveness analysis study of HPV testing as a primary cervical cancer screening in Thailand. Gynecol Oncol Rep 2017;22:58-63.
Knoema. World data atlas: Thailand - Mean age of childbearing. Knoema; 2020 [cited 2023 Apr 20]. Available from https://knoema.com/atlas/Thailand/topics/Demographics/Fertility
McIntyre-Seltman K, Lesnock JL. Cervical cancer screening in pregnancy. Obstet Gynecol Clin North Am 2008;35:645-58; x.
ACOG Committee Opinion No. 736: Optimizing postpartum care. Obstet Gynecol 2018;13:e140-e50.
Khaengkhor P, Mairaing K, Suwannarurk K, Thaweekul Y, Poomtavorn Y, Pattaraarchachai J, et al. Prevalence of abnormal cervical cytology by liquid based cytology in the antenatal care clinic, Thammasat University Hospital. J Med Assoc Thai 2011;94:152-8.
Ingprasarn A, Onaium N. Prevalence of abnormal conventional Pap smear in pregnant women, Chonburi Hospital. Thai J Obstet Gynaecol 2014;22:137.
Hong Y, Li SQ, Hu YL, Wang ZQ. Survey of human papillomavirus types and their vertical transmission in pregnant women. BMC Infect Dis 2013;13:109.
Liu P, Xu L, Sun Y, Wang Z. The prevalence and risk of human papillomavirus infection in pregnant women. Epidemiol Infect 2014;142:1567-78.
Brun-Micaleff E, Coffy A, Rey V, Didelot MN, Combecal J, Doutre S, et al. Cervical cancer screening by cytology and human papillomavirus testing during pregnancy in French women with poor adhesion to regular cervical screening. J Med Virol 2014;86:536-45.
Salcedo MM, Damin AP, Agnes G, Pessini SA, Beitune PE, Alexandre CO, et al. Prevalence of human papillomavirus infection in pregnant versus non-pregnant women in Brazil. Arch Gynecol Obstet 2015;292:1273-8.
Pandey D, Solleti V, Jain G, Das A, Shama Prasada K, Acharya S, et al. Human papillomavirus (HPV) infection in early pregnancy: prevalence and implications. Infect Dis Obstet Gynecol 2019;2019:4376902.
Domža G, Gudlevičienė Z, Didžiapetrienė J, Valuckas KP, Kazbarienė B, Drąsutienė G. Human papillomavirus infection in pregnant women. Arch Gynecol Obstet 2011;284:1105-12.
Nobbenhuis MA, Helmerhorst TJ, van den Brule AJ, Rozendaal L, Bezemer PD, Voorhorst FJ, et al. High-risk human papillomavirus clearance in pregnant women: trends for lower clearance during pregnancy with a catch-up postpartum. Br J Cancer 2002;87: 75-80.
Kantathavorn N, Mahidol C, Sritana N, Sricharunrat T, Phoolcharoen N, Auewarakul C, et al. Genotypic distribution of human papillomavirus (HPV) and cervical cytology findings in 5906 Thai women undergoing cervical cancer screening programs. Infect Agent Cancer 2015;10:7.
Bruni L, Diaz M, Castellsagué X, Ferrer E, Bosch FX, de Sanjosé S. Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. J Infect Dis. 2010;202:1789-99.
Sukvirach S, Smith JS, Tunsakul S, Muñoz N, Kesararat V, Opasatian O, et al. Population-based human papillomavirus prevalence in Lampang and Songkla, Thailand. J Infect Dis 2003;187:1246-56.
Chansaenroj J, Lurchachaiwong W, Termrungruanglert W, Tresukosol D, Niruthisard S, Trivijitsilp P, et al. Prevalence and genotypes of human papillomavirus among Thai women. Asian Pac J Cancer Prev 2010;11:117-22.
Sørbye SW, Suhrke P, Revå BW, Berland J, Maurseth RJ, Al-Shibli K. Accuracy of cervical cytology: comparison of diagnoses of 100 Pap smears read by four pathologists at three hospitals in Norway. BMC Clin Pathol 2017;17:18.
Sriamporn S, Kritpetcharat O, Nieminen P, Suwanrungraung K, Kamsa-ard S, Parkin DM. Consistency of cytology diagnosis for cervical cancer between two laboratories. Asian Pac J Cancer Prev 2005;6:208-12.