Pre-vaccination Prevalence and Genotype Distribution of Human Papillomavirus Infection among Women from Urban Tunis: a Cross-sectional Study

Background: To estimate the pre-vaccination distribution of human papillomavirus (HPV) types amongwomen from urban Tunis. Materials and
Methods: A total of 611 women aged 18-69 years were enrolled inthree local gynaecological outpatient departments. All underwent a gynaecological examination with Pap testand dry swab for HPV detection and typing performed by linear array genotyping test (Roche). Cytologicalexamination was conducted on conventional Pap smears.
Results: HPV DNA was found in 6.5% of the women;the most frequent HPV types were HPV 16 and HPV 11 at 3.27% and 1.96%, respectively. The second mostfrequent high risk (HR) HPV type was HPV 58 (0.82%) followed by HPV 18, HPV 31 and HPV 33 found inonly 0.33% of women. Single infections with HPV types, targeted by the quadrivalent vaccine (6, 11, 16, and18), were detected in 3.6 % of the study patients (55% of positive women). HPV infection was found in 3.83% ofwomen with normal cytology and in 47.4% of women with cytological abnormalities. No statistically significanttrend in prevalence by age group emerged for any HPV type or for high or low risk types.
Conclusions: Thesedata show a relatively low prevalence of HPV infection in women from urban Tunis with a high proportion ofHPV16 and HPV58. This should be considered in the upcoming screening programs and vaccination strategy.