Prevalence of Human Papillomavirus in Arica and Antofagasta, in the north of Chile

The infection by the Human Papillomavirus (HPV) is the most common sexually transmitted infection in the world, and probably the 80–90 % of people will be infected with HPV at some point in their lives [1]. This virus infects the basal epithelial cells of the cell membrane, where it reproduces causing cutaneous warts on the hands, feet and in the anogenital regions, lesions classified as benign or non-oncogenic [2]. However, some HPV genotypes are responsible for infections that can lead to certain types of cancer, such as cervical, vulvar, oropharyngeal, and vaginal cancer [3], [4]. More than 200 HPV genotypes are known, which have been grouped into two categories: Low Risk, non-oncogenic (LR-HPV), which include types 6, 11, 42, 43 and 44; and High Oncogenic Risk (HR-HPV), which includes types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68, related to high-grade lesions and cervical cancer [2], [5].

HPV is the most common cause of cervical cancer, being involved in 99.7 % of cases of cervical squamous cell carcinoma, while genotypes 16 and 18 are the most common worldwide and are associated to the 70 %-78 % of cervical cancer cases [6], [7], [8], [9]. Cervical cancer has a worldwide incidence of 14.1/100,000 inhabitants, and a mortality rate of 7.1/100,000 inhabitants, making it the fifth most common cancer worldwide, and the fourth most common in women, recording 340,000 deaths and 600,000 new cases each year [10]. In Chile, the situation is slightly smaller, with an incidence of 11.3/100,000 inhabitants, and a mortality rate of 5.2/100,000 inhabitants. In 2022 were registered 1559 new cases of cervical cancer and 825 deaths in this country [10]. Regarding the global prevalence of HPV in women, it is estimated at 10.4 %, with 32 % of these infections with high-risk genotypes [11], [12]. The HPV prevalence recorded in Chile is 16 % in women, according to the Public Health Institute of Chile [13]. Previously, we recorded an HPV prevalence of 26.56 % in women living in the Coquimbo region, in north-central Chile [14], which was interesting for us and prompted us to look for HPV prevalence further north in the country. In this regard, it is worth mentioning that Chile is a vast country, 4270 km long and with an only 445–90 km wide. Furthermore, the climates are extremely different between southern and northern Chile, with lush vegetation and a rainy climate in the south, versus a desert landscape in the north with an almost absence of rain. Thus, although the National Health System is the same throughout our country, the populations are very different in both ends, not to mention the large migrant population that has arrived in recent years.

The World Health Organization (WHO), in its “Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem”, adopted in 2020, proposes to carry out a high-precision molecular screening test to detect HPV, starting at age 35 [15]. In this regard, primary HPV testing every 5 years for ages 30–50 years would result in a 60 % or greater reduction in cervical cancer compared with no screening [16]. The widespread use of molecular techniques for the detection of HPV could significantly improve the effectiveness of cervical cancer prevention programs, preventing the development of cancer in the population.

Based on these data, we aim to determine the prevalence of HPV and its genotypes in the regions of Arica and Antofagasta, in the far north of Chile.

Comments (0)

No login
gif