Seroprevalence of Human Papillomavirus Type 16 Infection in the United States

Infection with human papillomavirus (HPV) type 16 accounts for about half of cervical cancers worldwide.This study investigated the seroepidemiology of HPV-16 infection in the United States by using a population-based survey.Serum samples and questionnaire data were collected from 1991 to 1994 for the National Health and Nutrition Examination Surveys.HPV-16-specific IgG antibody was detected by use of an HPV-16 virus-like particle ELISA.HPV-16 seropositivity in the US population aged 12-59 years was 13.0% (95% confidence interval, 11.5%-14.7%).Seroprevalence was higher in women (17.9%) than in men (7.9%).Age, race/ethnicity, and number of lifetime sex partners were associated with HPV seropositivity in women.Race/ethnicity, age at first intercourse, urban/nonurban residence, years of sexual activity, and having had sex with a man were associated with HPV seropositivity in men.Information on HPV-16 seroepidemiology will be important for designing prevention efforts including vaccine programs.Genital human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States 1,2.At least 30 HPV types infect the genital area, and persistent infection with high-risk HPV types is the strongest risk factor for cervical cancer.High-risk HPV types, including 16, 18, 31, 33, and 35, are found in up to 93% of cervical cancers worldwide, and HPV-16 accounts for 50% 3456.Assessing the extent of genital HPV infection in the US population has been difficult for many reasons.HPV does not grow in tissue culture, closely related types cause different diseases (e.g., cervical cancer and genital warts), and most infections are asymptomatic.No surveillance systems exist, and no large population-based prevalence surveys have been feasible.Current knowledge of HPV prevalence and risk factors is based largely on measuring viral DNA in genital epithelial cells.How-