Background: Nearly 500,000 new cases of cervical cancer are estimated annually worldwide. Three vaccines are currently licensed to prevent cervical cancer. The success of vaccination depends mainly on the prevalence of HPV genotypes, and many cases of HPV infection have been diagnosed after vaccination. Our aim was to search for HPV genotyping in cervical samples to verify the proportion of women that remain susceptible to infection even after vaccination. Methods: 21,017 liquid-based cervical (LBC) specimens were received for cytology and HPV detection from 2015 to 2018. Before slide preparations for cytology, a 1,000-μL aliquot was taken from the LBC fixative and subjected to automated DNA extraction and multiplex PCR followed by capillary electrophoresis to detect and classify HPV. Results: HPV was detected in 895 (4.3%) specimens. The most prevalent genotype was HPV-16, followed by HPV-58 and HPV-66. A total of 258 (28.8%) cases were positive for high-risk (HR)-HPV types (66, 59, 39, 56, 30, 35, 53, 51, 68, 82, and 70) that are not covered by the HPV vaccines. Conclusion: A significant proportion of HPV types detected in cytological specimens are representative of HR-HPV not covered by the available vaccines. The health system should be aware of the considerable percentage of women who are not being immunized and will continue to need cervical cancer screening.

1.
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
Dec
;
202
(
12
):
1789
99
.
[PubMed]
0022-1899
2.
de Oliveira
CM
,
Fregnani
JH
,
Villa
LL
,
Vaccine
HP
.
Updates and Highlights
.
Acta Cytol
.
2019
;
63
(
2
):
159
68
.
[PubMed]
0001-5547
3.
Romanowski
B
,
de Borba
PC
,
Naud
PS
,
Roteli-Martins
CM
,
De Carvalho
NS
,
Teixeira
JC
, et al;
GlaxoSmithKline Vaccine HPV-007 Study Group
.
Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6.4 years
.
Lancet
.
2009
Dec
;
374
(
9706
):
1975
85
.
[PubMed]
0140-6736
4.
Franco
EL
,
Villa
LL
,
Ruiz
A
,
Costa
MC
.
Transmission of cervical human papillomavirus infection by sexual activity: differences between low and high oncogenic risk types
.
J Infect Dis
.
1995
Sep
;
172
(
3
):
756
63
.
[PubMed]
0022-1899
5.
Martins
TR
,
Mendes de Oliveira
C
,
Rosa
LR
,
de Campos Centrone
C
,
Rodrigues
CL
,
Villa
LL
, et al
HPV genotype distribution in Brazilian women with and without cervical lesions: correlation to cytological data
.
Virol J
.
2016
Aug
;
13
(
1
):
138
.
[PubMed]
1743-422X
6.
Rocha
DA
,
Barbosa Filho
RA
,
de Queiroz
FA
,
Dos Santos
CM
.
High prevalence and genotypic diversity of the human papillomavirus in Amazonian women, Brazil
.
Infect Dis Obstet Gynecol
.
2013
;
2013
:
514859
.
[PubMed]
1064-7449
7.
Castro
MM
,
Farias
IP
,
Borborema-Santos
CM
,
Correia
G
,
Astolfi-Filho
S
.
Prevalence of human papillomavirus (HPV) type 16 variants and rare HPV types in the central Amazon region
.
Genet Mol Res
.
2011
Feb
;
10
(
1
):
186
96
.
[PubMed]
1676-5680
8.
Fonseca
AJ
,
Taeko
D
,
Chaves
TA
,
Amorim
LD
,
Murari
RS
,
Miranda
AE
, et al
HPV Infection and Cervical Screening in Socially Isolated Indigenous Women Inhabitants of the Amazonian Rainforest
.
PLoS One
.
2015
Jul
;
10
(
7
):
e0133635
.
[PubMed]
1932-6203
9.
C.M.
Correa
,
N.C.
Teixeira
,
A.C.
Araujo
,
O.
Carvalho Nde
,
D.M.
Castillo
,
R.R.
Campos
,
I.V.
Oliveira
,
A.R.
Alves
,
A.F.
Franca
,
V.H.
Melo
, Prevalence and multiplicity of HPV in HIV women in Minas Gerais, Brazil, Rev Assoc Med Bras (1992) 57(4) (
2011
) 425-30.
10.
Coser
J
,
da Rocha Boeira
T
,
Simon
D
,
Kazantzi Fonseca
AS
,
Ikuta
N
,
Lunge
VR
.
Prevalence and genotypic diversity of cervical human papillomavirus infection among women from an urban center in Brazil
.
Genet Mol Res
.
2013
Feb
;
12
(
4
):
4276
85
.
[PubMed]
1676-5680
11.
Serrano
B
,
de Sanjosé
S
,
Tous
S
,
Quiros
B
,
Muñoz
N
,
Bosch
X
, et al
Human papillomavirus genotype attribution for HPVs 6, 11, 16, 18, 31, 33, 45, 52 and 58 in female anogenital lesions
.
Eur J Cancer
.
2015
Sep
;
51
(
13
):
1732
41
.
[PubMed]
0959-8049
12.
Tota
JE
,
Ramanakumar
AV
,
Jiang
M
,
Dillner
J
,
Walter
SD
,
Kaufman
JS
, et al
Epidemiologic approaches to evaluating the potential for human papillomavirus type replacement postvaccination
.
Am J Epidemiol
.
2013
Aug
;
178
(
4
):
625
34
.
[PubMed]
0002-9262
13.
Giuliano
AR
,
Lee
JH
,
Fulp
W
,
Villa
LL
,
Lazcano
E
,
Papenfuss
MR
, et al
Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study
.
Lancet
.
2011
Mar
;
377
(
9769
):
932
40
.
[PubMed]
0140-6736
14.
Lehtinen
M
,
Paavonen
J
,
Wheeler
CM
,
Jaisamrarn
U
,
Garland
SM
,
Castellsagué
X
, et al;
HPV PATRICIA Study Group
.
Overall efficacy of HPV-16/18 AS04-adjuvanted vaccine against grade 3 or greater cervical intraepithelial neoplasia: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial
.
Lancet Oncol
.
2012
Jan
;
13
(
1
):
89
99
.
[PubMed]
1470-2045
15.
Xia
C
,
Hu
S
,
Xu
X
,
Zhao
X
,
Qiao
Y
,
Broutet
N
, et al
Projections up to 2100 and a budget optimisation strategy towards cervical cancer elimination in China: a modelling study
.
Lancet Public Health
.
2019
Sep
;
4
(
9
):
e462
72
.
[PubMed]
2468-2667
16.
Simms
KT
,
Steinberg
J
,
Caruana
M
,
Smith
MA
,
Lew
JB
,
Soerjomataram
I
, et al
Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020-99: a modelling study
.
Lancet Oncol
.
2019
Mar
;
20
(
3
):
394
407
.
[PubMed]
1470-2045
17.
Mesher
D
,
Soldan
K
,
Lehtinen
M
,
Beddows
S
,
Brisson
M
,
Brotherton
JM
, et al
Population-Level Effects of Human Papillomavirus Vaccination Programs on Infections with Nonvaccine Genotypes
.
Emerg Infect Dis
.
2016
Oct
;
22
(
10
):
1732
40
.
[PubMed]
1080-6040
18.
Malagón
T
,
Drolet
M
,
Boily
MC
,
Franco
EL
,
Jit
M
,
Brisson
J
, et al
Cross-protective efficacy of two human papillomavirus vaccines: a systematic review and meta-analysis
.
Lancet Infect Dis
.
2012
Oct
;
12
(
10
):
781
9
.
[PubMed]
1473-3099
19.
J.M.L.
Brotherton
,
S.N.
Tabrizi
,
S.
Phillips
,
J.
Pyman
,
A.M.
Cornall
,
N.
Lambie
,
L.
Anderson
,
M.
Cummings
,
D.
Payton
,
J.P.
Scurry
,
M.
Newman
,
R.
Sharma
,
M.
Saville
,
S.M.
Garland
, Looking beyond human papillomavirus (HPV) genotype 16 and 18: Defining HPV genotype distribution in cervical cancers in Australia prior to vaccination, International journal of cancer. Journal international du cancer 141(8) (
2017
) 1576-1584.
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