Abstract | Objectives: Kosovo’s current health care system does not support organized
nationwide cervical cancer screening and human papillomavirus (HPV)
vaccination programs. To date, no reliable data are available on cervical
cancer incidence and mortality in Kosovo, or on high-risk HPV (hr-HPV)
prevalence and HPV type distribution. Our aim is to determinate the prevaccination
prevalence and distribution of hr-HPVs and to assesses the
associations between sociodemographic characteristics and increased risk of
HPV infection in women from Kosovo. -----
Methods: Detection of hr-HPV DNA was performed in cervical swabs of
women that underwent routine gynecological and cytological evaluation by
using a clinically validated Abbott RealTime High Risk HPV test, Roche Linear
Array HPV Genotyping Test, HPV52 type-specific real-time PCR and an inhouse
GP5+/GP6+/68 PCR. -----
Results: The crude overall prevalence of any of the hr-HPVs was estimated at
13.1% (26/199; 95% confidence interval (CI): 9.1–18.5%), with HPV16 being
the most common type (7/26; 26.9%), followed by HPV31 and HPV51, each
detected in 4/26 (15.4%) cervical specimens, HPV18, detected in 3/26 (11.5%) specimens, HPV52 and HPV66, each detected in 2/26 (7.7%) specimens, and
HPV33, HPV45, HPV56, and HPV58, each detected in a single (3.9%)
specimen. Women over 40 (OR = 0.36), older than 18 at sexual debut (odds
ratio (OR) = 0.28), those that had delivered at least one child (OR = 0.32), and
those that had a history of pregnancy termination (OR = 0.39) were at lower
risk for HPV infection. -----
Conclusion: Because more than 70% of cervical precancerous lesions could
have been prevented in Kosovo using nationwide HPV-based cervical cancer
screening and HPV vaccination, it is of outmost importance to implement both
programs in the national health care system as soon as possible. |
Abstract (croatian) | Ciljevi: Trenutačni sustav zdravstvene zaštite Kosova ne podržava
organizirani nacionalni probir karcinoma vrata maternice i program cijepljenja
protiv human papiloma virusa (HPV). Do sada, nisu dostupni pouzdani podaci
o incidenciji i mortalitetu raka vrata maternice na Kosovu, takoder ni o
prevalencije visokorizičnih HPV-a i raspodjela HPV tipova. Cilj nam je utvrditi
prevalenciju i raspodjelu visokorizičnih HPV tipova prije cijepljenja i procijeniti
povezanost sociodemografskih obilježja i povećanog rizika od HPV infekcije u
žena s Kosova. -----
Metode: Detekcija DNK visokorizičnih HPV tipova u cervikalnim obriscima
žena koje su bile na rutinskoj ginekološkoj i citološkoj obradi provedena je
primjenom klinički validiranog HPV testa, Abbott RealTime HPV testa, Roche
Linear Array HPV genotipizacijskog testa, HPV52 tip-specifičnog realnog PCRa
i GP5 + / GP6 + / 68 PCR. -----
Rezultati: Ukupna prevalencija svih HPV-a visokog rizika procijenjena je na
13,1% (26/199, 95% intervala pouzdanosti (CI): 9,1-18,5%), pri čemu je
HPV16 najčešći tip (7/26; 26,9 %), zatim HPV31 i HPV51, od kojih je svaki
detektiran u 4/26 (15,4%) cervikalnih uzoraka, HPV18, detektiran u 3/26
(11,5%) uzoraka, HPV52 i HPV66, svaki detektiran u 2/26 (7,7%) uzoraka , i
HPV33, HPV45, HPV56 i HPV58, svaki detektiran u jednom (3,9%) uzorku.
Žene iznad 40 godina (OR = 0,36), starije od 18 godina pri prvom spolnom
odnosu (omjer vjerojatnosti (OR) = 0,28), one koji su rodile barem jedno dijete
(OR = 0,32), i one koje su imale prestanak trudnoće (OR= 0,39) imale su niži
rizik za HPV infekciju. -----
Zaključak: Obzirom na to da bi se na Kosovu moglo spriječiti više od 70%
prekanceroznih lezija vrata maternice pomoću HPV cjepiva protiv raka vrata
maternice i cjepiva protiv HPV-a na nacionalnoj razini, od najveće je važnosti
što prije implementirati preventivne programe u nacionalnom zdravstvenom
sustavu. |