The Prevalence of Human Papilloma Virus Infection and Its High Risk Genotypes among Healthy Women in 28 Provinces in Iran: A Systematic Review and Meta-Analysis
A Systematic Review and Meta-Analysis
Abstract
Introduction: Human Papilloma Virus infection (HPV) high-risk genotypes are responsible for up to 70% of invasive cervical cancers. It was aimed to determine the national and provincial prevalence of the total HPV and its high-risk genotypes including HPV genotype 16 (HPV16) and HPV genotype 18 (HPV18), and HPV genotypes other than genotypes of 16 and 18 (HPV other genotypes) among Iranian healthy women.
Methods: Iran with 28 provinces locates at latitude and longitude of 32° 00' north and 53° 00' east. All Persian and English studies reporting HPV infection based on cervical specimens were selected through searching the PubMed, Magiran, Scopus, Irandoc databases, and Google Scholar research search engine. Sample size and event rates were used to compute the overall event rates and 95% confidence interval (95% C.I); Fixed or random effects model, heterogeneity indices including Q-statistics (p-value), and degree of heterogeneity (I2) were reported. The search was done up to February 29, 2022. Comprehensive Meta-analysis 2.2.064 and ArcGIS 10.8.2 software tools were used at a significance level of <0.05.
Results: The meta-analysis included nineteen studies with 258839 participants. The national meta-analysis resulted in a total HPV prevalence of 0.025 (95% C.I 0.016, 0.039); those of HPV16, HPV18, and HPV other genotypes were 0.032 (95% C.I 0.019, 0.051), 0.028 (95% C.I 0.019, 0.040), and 0.048 (95% C.I 0.033,
0.069), respectively. The provincial meta-analysis showed that the total HPV prevalence was highest in Zanjn and Kerman (0.323 and 0.240, respectively); that of HPV16 was highest in Boushehr and Khozestan (0.298 and 0.253, respectively); that of HPV18 was highest in Tehran (0.089) and that of HPV other genotypes was highest in Khozestan (0.542).
Conclusion: The current results would help policymakers and health managers accentuate on further implementation of screening strategies and health services in needier areas such as Zanjan, Kerma, Khozestan, and Tehran.
2. De Villiers E-M, Fauquet C, Broker TR, Bernard H-U, Zur Hausen HJV. Classification of papillomaviruses. Virology. 2004;324(1):17-27.
3. Bihl MP, Tornillo L, Kind AB, Obermann E, Noppen C, Chaffard R, et al. Human papillomavirus (HPV) detection in cytologic specimens: similarities and differences of available methodology. Appl Immunohistochem Mol Morphol. 2017;25(3):184.
4. Kaliterna V, Barisic ZJFiB-L. Genital human papillomavirus infections. Front Biosci (Landmark Ed). 2018;23(9):1587-611.
5. Schmitt M, Depuydt C, Benoy I, Bogers J, Antoine J, Arbyn M, et al. Prevalence and viral load of 51 genital human papillomavirus types and three subtypes. Int J Cancer. 2013;132(10):2395-403.
6. Eghbali SS, Amirinejad R, Obeidi N, Mosadeghzadeh S, Vahdat K, Azizi F, et al. Oncogenic human papillomavirus genital infection in southern Iranian women: population-based study versus clinic-based data. Virol J. 2012;9:1-6.
7. NEWCASTLE-OTTAWA QUALITY ASSESEMENT SCALE ( adapted for cross sectional studies). https://cdn-linkslwwcom/ permalink/ejgh/a/ejgh_31_9_2019_07_18_ nguyen_15743_sdc1pdf.
8. Dettori JR, Norvell DC, Chapman JRJGSJ. Fixed-effect vs random-effects models for meta-analysis: 3 points to consider. Global Spine Journal. 2022;12(7):1624-6.
9. Afonso J, Ramirez-Campillo R, Clemente FM, Büttner FC, Andrade RJSm. The Perils of Misinterpreting and Misusing “Publication Bias” in Meta-analyses: An Education Review on Funnel Plot-Based Methods. Sports Med. 2023:1-13.
10. Sohrabi A, Hajia MJIJoP. Cervical cancer and genital infections: assessment of performance and validation in human papillomavirus genotyping assays in Iran, its neighbouring countries and Persian Gulf area. Iran J Pathol. 2017;12(1):35-44.
11. Malary M, Moosazadeh M, Hamzehgardeshi Z, Afshari M, Moghaddasifar I, Afsharimoghaddam AJIjopm. The prevalence of cervical human papillomavirus infection and the most at-risk genotypes among Iranian healthy women: A systematic review and meta- analysis. Int J Prev Med. 2016;7.
12. Raza S, Franceschi S, Pallardy S, Malik F, Avan B, Zafar A, et al. Human papillomavirus infection in women with and without cervical cancer in Karachi, Pakistan. Br J Cancer. 2010;102(11):1657-60.
13. Abike F, Bingöl B, Yılmaz A, Temizkan O, Tapısız ÖL, Dunder İ. HPV infection and HPV subtypes in normal and abnormal cervical cytology in Turkish women. J Virol Microbiol. 2013;2013(2013):1-7.
14. Sabeena S, Bhat PV, Kamath V, Bhat SK, Nair S, Ravishankar N, et al. Community- based prevalence of genital human papilloma virus (HPV) infection: a systematic review and meta-analysis. Asian Pac J Cancer Prev. 2017;18(1):145-54.
15. Mobini Kesheh M, Kafashi A, Bagheri G, Shahkarami MK, Mohamadi M, Nadji SAJTIJoO, Gynecology, et al. Identification of human papillomavirus type 16 among thinprep samples from 11 provinces of Iran. Iranian journal of obstetrics, gynecology, and infertility. 2013;16(72):22-8.
16. Kesheh MM, Keyvani HJIjop. The prevalence of HPV genotypes in Iranian population: An Update. Iran J Pathol. 2019;14(3):197.
17. Moeinzadeh M, Kheirkhah B, Amini K, Pouryasin AJBB. Classification and identification of human papillomavirus based on its prevalence and development of cervical lesion among Iranian women. Bioimpacts. 2020;10(4):235.
18. Farahmand Z, Soleimanjahi H, Garshasbi M, Hasanzadeh M, Zafari EJW, Health. Distribution of the most common types of HPV in Iranian women with and without cervical cancer. Women Health. 2021;61(1):73-82.
19. Ghaffari SR, Sabokbar T, Mollahajian H, Dastan J, Ramezanzadeh F, Ensani F, et al. Prevalence of human papillomavirus genotypes in women with normal and abnormal cervical cytology in Iran. Asian Pac J Cancer Prev. 2006;7(4):529-32.
20. JAMALI ZM, Hamkar R, Ghobadi DV, Delforoush M, SHOJA MM, MODARES GM. Prevalence of HPV infection and its association with cytological abnormalities of Pap smears in Tehran. Iranian J Publ Health. 2008;37(3):101-6.
21. Jamdar F, Farzaneh F, Navidpour F, Younesi S, Balvayeh P, Hosseini M, et al. Prevalence of human papillomavirus infection among Iranian women using COBAS HPV DNA testing. Infect Agent Cancer. 2018;13(1):1-5.
22. Khodakarami N, Clifford GM, Yavari P, Farzaneh F, Salehpour S, Broutet N, et al. Human papillomavirus infection in women with and without cervical cancer in Tehran, Iran. Int J Cancer. 2012;131(2):E156-E61.
23. Jamshidi Makiani M, Minaeian S, Moghaddam SA, Moosavi SA, Moeini Z, Zamani V, et al. Relative frequency of human papillomavirus genotypes and related sociodemographic characteristics in women referred to a general hospital in Tehran, 2014- 2015: A cross-sectional study. Int J Reprod Biomed. 2017;15(5):305-10.
24. Shafaghi B, Jarollahi A, Yousefzadeh B, Ameri A, Moghadam S, Mostafavi MJRoR, et al. Human papilloma virus prevalence and types among Iranian women attending regular gynecological visits. Reports of Radiotherapy and Oncology. 2013;1(2):73-9.
25. Yousefzadeh A, Mostafavizadeh SM, Jarollahi A, Raeisi M, Garshasbi M, Siavashvahabi Z, et al. Human papillomavirus (HPV) prevalence and types among women attending regular gynecological visit in Tehran, Iran. Clin Lab. 2014;60(2):267-73.
26. Shahramian I, Heidari Z, Mahmoudzadeh-Sagheb H, Moradi A, Forghani FJIJoPH. Prevalence of HPV infection and high risk HPV genotypes (16, 18), among monogamous and polygamous women, in Zabol, Iran. Iran J Public Health. 2011;40(3):113.
27. Hamkar R, Azad TM, Mahmoodi M, Seyedirashti S, Severini A, Nategh RJE- EMHJ, 8 , 805-811,. Prevalence of human papillomavirus in Mazandaran province, Islamic Republic of Iran. East Mediterr Health J. 2002;8(6):805-1.
28. Afshar RM, Mollaie HR, Fazlalipour M, Arabzadeh SAJAPjocp. Prevalence and type distribution of human papillomavirus infection using the INNo-Lipa assay, Kerman, Southeast Iran. Asian Pac J Cancer Prev. 2013;14(9):5287-91.
29. Moradi A, Nosrat SB, Besharat SJIjocp. Molecular epidemiology of high-risk types of human papillomaviruses (16, 18) in pap- smear, the North East of Iran. Iran J Cancer Prev. 2011;4(3):135-40.
30. Mehran SMM, Ghanaei MM, Mojtehadi AJJoC, JCDR DR. The prevalence of human papilloma virus (HPV) in women using liquid base pap smear in Rasht, Northern of Iran. J Clin Diagn Res. 2015;9(7):IC01-IC2.
31. Safaei A, Khanlari M, Momtahen M, Monabati A, Robati M, Amooei S, et al. Prevalence of high-risk human papillomavirus types 16 and 18 in healthy women with cytologically negative pap smear in Iran. Indian J Pathol Microbiol. 2010;53(4):681.
32. Zandi K, Eghbali SS, Hamkar R, Ahmadi S, Deilami I, Nejad HA, et al. Prevalence of various human papillomavirus (HPV) genotypes among women who subjected to routine Pap smear test in Boushehr city (south west of Iran) 2008-2009. Virol J. 2010;7(1):1-4.
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Issue | Vol 9 No 2 (2023) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/jbe.v9i2.14625 | |
Keywords | ||
Women's Health HPV Prevalence HPV Genotypes Cervical Cancer Meta-Analysis Epidemiology Iran |
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