Journal of Infectious Diseases
Volume 204 Issue 4 August 15, 2011
http://www.journals.uchicago.edu/toc/jid/current

Eileen F. Dunne, Maya Sternberg, Lauri E. Markowitz, Geraldine McQuillan, David Swan, Sonya Patel, and Elizabeth R. Unger
Human Papillomavirus (HPV) 6, 11, 16, and 18 Prevalence Among Females in the United States—National Health and Nutrition Examination Survey, 2003–2006: Opportunity to Measure HPV Vaccine Impact?
J Infect Dis. (2011) 204(4): 562-565 doi:10.1093/infdis/jir342

Abstract
The 2003–2006 National Health and Nutrition Examination Surveys were used to assess human papillomavirus (HPV) types 6, 11, 16, and 18 DNA detection from females aged 14–59 years who self-collected cervicovaginal swab specimens. Prevalence was 8.8% (95% confidence interval [CI], 7.8%–10.0%) and was highest among women aged 20–24 years (18.5%; 95% CI, 14.9%–22.8%). Age group, education, marital status, and sexual behavior were associated with detection. These data provide baseline information before HPV vaccine introduction. Early impact of vaccine in the United States may be determined by a reduction in the prevalence of HPV 6, 11, 16, and 18 infection among young women.

Susan Hariri, Elizabeth R. Unger, Maya Sternberg, Eileen F. Dunne, David Swan, Sonya Patel, and Lauri E. Markowitz
Prevalence of Genital Human Papillomavirus Among Females in the United States, the National Health and Nutrition Examination Survey, 2003–2006
J Infect Dis. (2011) 204(4): 566-573 doi:10.1093/infdis/jir341

Abstract
Background. Genital human papillomaviruses (HPV) include  >40 sexually transmitted viruses. Most HPV infections do not progress to disease, but infection with certain types of HPV can cause cervical and other anogenital and oropharyngeal cancer, and other types of HPV are associated with anogenital warts. HPV vaccines prevent infection with HPV 16 and 18, which account for 70% of cases of cervical cancer, and HPV 6 and 11, which cause 90% of the cases of anogenital warts.

Methods. Using  data and self-collected cervicovaginal specimens from 4150 females, 14–59 years of age, from consecutive National Health and Nutrition Examination Surveys (2003–2006), we estimated the prevalence of type-specific HPV DNA and examined sociodemographic and sexual determinants.

Results. The  overall prevalence of HPV was 42.5% in females 14–59 years of age and varied significantly by age, race or ethnicity, and number of sex partners. Individual type prevalence was less than 7%, ranging from <0.5% through 6.5%. The most common type was nononcogenic HPV 62 (found in 6.5% of subjects), followed by HPV 53 and HPV 16 (4.7%), both of which are oncogenic types. The most prevalent species was nononcogenic α3.

Conclusions. HPV infection is common among US females, with the highest burden of  infection found in young females 20–24 years of age. Monitoring trends in HPV type distribution will contribute to our understanding of the early impact of HPV vaccines.