Decreasing prevalence of HPV16 & 18 genotypes in young New Zealand women with biopsy-diagnosed CIN2 — YRD

Decreasing prevalence of HPV16 & 18 genotypes in young New Zealand women with biopsy-diagnosed CIN2 (3504)

Peter Sykes 1 2 , Carrie RH Innes 1 , Rachael van der Griend 3 , Peter Fitzgerald 4 , Bryony Simcock 1 2
  1. Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand
  2. Canterbury District Health Board, Christchurch, New Zealand
  3. Canterbury Health Labs, Christchurch, Canterbury, New Zealand
  4. Southern Community Laboratories, Dunedin, Otago, New Zealand

The PRINCess (CIN2 observational management in women <25 years) trial recruited n=610 women between 2010 – 2016. However, routine partial human papillomavirus (HPV) genotyping only began in 2013. We report on the prevalence of HPV genotypes at initial CIN2 diagnosis for n=296 PRINCess participants between 2013 and 2016. These women (mean age 21.7, range 16–24) had biopsy-diagnosed CIN2 following a referral to colposcopy for an abnormal smear with no previous high grade abnormality. In 2013, 44% of PRINCess women tested positive for HPV type 16 (HPV16) or 18 (HPV18), 51% tested positive for other high risk HPV (HRHPV) genotypes, and HRHPV was not detected in 5%. The proportion of HPV16 or 18 positive CIN2 lesions decreased to 30% and 27%, respectively in 2014 and 2015. In 2016, only 9% of CIN2 lesions were HPV 16 or 18 positive with 89% testing positive for other HRHPV genotypes. While the rate of high grade cervical abnormalities in young NZ women does not appear to have changed greatly between 2013 and 2016, the proportion of HPV16 or 18 positive CIN2 lesions has decreased substantially. We speculate that this reduction in HPV16 and 18 positivity in young women is due to the introduction of the HPV vaccine in NZ in 2009. The impact of the reduction in HPV16 and 18 positivity on the probability of spontaneous regression of these CIN lesions is currently unknown but will be an important outcome measure for PRINCess (and for our proposed CIN3 observational management study).