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Distribution of high and low risk HPV types by cytological status: a population based study from Italy

Paolo Giorgi Rossi1*, Francesco Chini1, Simonetta Bisanzi2, Elena Burroni2, Giuseppe Carillo3, Amedeo Lattanzi4, Claudio Angeloni4, Aurora Scalisi5, Rosalba Macis6, Maria T Pini7, Paola Capparucci8, Gabriella Guasticchi1, Francesca M Carozzi2 and the Prevalence Italian Working Group.HPV

Author Affiliations

1 Laziosanità - Agency for Public Health, Lazio Region. Via di S. Costanza 53, 00198 - Rome, Italy

2 Analytical and Biomolecular Cytology Unit, Cancer Prevention and Research Institute, ISPO, Via Cosimo il Vecchio 2, Florence - 50139, Italy

3 Anatomia Patologica, Ospedale G. Moscati, ASL Caserta 2, Aversa (CE) - 81021, Italy

4 Coordinamento Screening, ASL Teramo, Teramo - 64100, Italy

5 Coordinamento Screening, ASL Catania, Catania - 95124, Italy

6 Anatomia Patologica, ASL Cagliari 09125, Italy

7 Coordinamento Screening, Dipartimento Materno Infantile, ASL Napoli 2, Giugliano in Campania (NA) - 80014, Italy

8 Coordinamento Screening ASL Roma C, Rome, Italy

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Infectious Agents and Cancer 2011, 6:2  doi:10.1186/1750-9378-6-2

Published: 20 January 2011



HPV type distribution by cytological status represents useful information to predict the impact of mass vaccination on screening programs.


women aged from 25 to 64 who attended cervical cancer screening in five different Italian regions were tested for HPV infection with Hybrid Capture II (HCII) low and high risk probes. Women repeating Pap-test upon unsatisfactory or positive results, or as a post-treatment and post-colposcopy follow-up analysis, were excluded from our study. High risk (HR) HPV positive samples were typed using GP5+/GP6+ primed PCR, followed by Reverse Line Blot for 18 high/intermediate risk HPV types, while low risk (LR) HPV positive samples were tested with type specific primers for HPV6 and HPV11.


3410 women had a valid HCII and Pap-test. The prevalence of HR and LR infections was 7.0% and 3.6%, 29.1% and 13.7%, 68.1% and 31.9%, 60.0% and 0.0%, 65.0% and 12.0%, for negative, ASC-US, L-SIL, ASC-H and H-SIL cytology, respectively. The fraction of ASC-US+ cytology due to HPV 16 and 18 ranged from 11.2 (HPV 16/18 alone) to 15.4% (including HPV 16/18 in co-infection with other virus strains), and that due to HPV 6 and 11 ranged from 0.2% (HPV 6/11 alone) to 0.7% (including HPV 6/11 in co-infection with other LR virus strains).


mass vaccination with bivalent or quadrivalent HPV vaccine would modestly impact on prevalence of abnormal Pap-test in screening.