Human Papilloma Virus (HPV) Prevalence and Subtypes among Turkish Women attending a Gynecology Outpatient Unit

Background Human Papilloma virus (HPV) is a well-known pathogen for lower genital tract neoplasias, yet little is known regarding HPV prevalence in Turkey. The aim of this study was to investigate the prevalence of HPV DNA and to determine HPV subtypes distribution among women with normal and abnormal cytology. Material&Method A total of five hundred seven (n=507) women were retrospectively evaluated between 2004– 2008. Conventional polymerase chain reaction was used to detect the presence of HPV subtypes in cervicovaginal samples obtained from patients during gynecologic examination. Results One hundred four (n=104) of the women were excluded from the study because of the incomplete data and a total of 403 women were used for the final analysis. There were, 93 (23%) women with cytologic abnormality and 310 (77%) women with normal cytology. Overall, 23 % of the women was HPV positive. The overall prevalence of HPV in women with abnormal Pap smears was 36% (93/403), of which in ASCUS 22%, LSIL 51% and HSIL 60%. Also, HPV DNA was positive in 20 % of the women with normal cervical cytology. The most common HPV types in cytologically normal women were as follows; HPV 16 (36%), HPV 6 ( 22%) and HPV 18 (13%). The rate of other HPV types were as follows; HPV 11 4.4%, HPV 45 4.4%, HPV 90 4.4%, HPV 35 2.2%, HPV 67 2.2%, HPV 81 2.2%, and multiple type HPVs 8.9%. The most common HPV types in cytologically abnormal women were HPV 16 (35%), HPV 6 (19%) and HPV 18 (8%). The rate of multiple HPV infections in women with normal Pap test was 2.2 %. Conclusion HPV prevalence and type distribution in this study similar to that reported worldwide at least in our study population. Hovewer, HPV prevalence was more common compared with previous studies reported from Turkey. This might be related with methodology and hospital based patient accrual and high rate of women with abnormal cytology. Further population based prospective studies are needed to eliminate the drawbacks of our study and to determine nonhospital based HPV prevalence in Turkish women.