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@ARTICLE{Liang:293348,
      author       = {L. A. Liang and L. F. Tanaka and K. Radde and U. Bussas$^*$
                      and H. Ikenberg and D. A. M. Heideman and C. J. L. M. Meijer
                      and M. Blettner and S. J. Klug},
      title        = {{P}opulation-based age- and type-specific prevalence of
                      human papillomavirus among non-vaccinated women aged 30
                      years and above in {G}ermany.},
      journal      = {BMC infectious diseases},
      volume       = {24},
      number       = {1},
      issn         = {1471-2334},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2024-01894},
      pages        = {1008},
      year         = {2024},
      abstract     = {A persisting high-risk human papillomavirus (HR-HPV)
                      infection is causal for cervical cancer; however, there is
                      limited population-based data on the prevalence of HPV
                      infections in Germany. We assessed the age and type-specific
                      HPV prevalence, and associated risk factors in HPV
                      unvaccinated women aged 30 and above.The MARZY prospective
                      population-based cohort study was conducted between 2005 and
                      2012 in Mainz and Mainz-Bingen, Germany. Eligible women were
                      randomly recruited from population registries and invited
                      for cervical cancer screening (n = 5,275). A study swab
                      (liquid-based cytology) was taken and HPV testing was
                      performed with GP5+/6 + polymerase chain reaction (PCR)
                      followed by genotyping. We assessed HPV types as HR-HPV,
                      'moderate' risk and low-risk (LR-HPV). Logistic regression
                      was performed to identify factors associated with HPV
                      infection, stratified by HPV types.2,520 women were screened
                      with a valid PCR result. Overall HPV prevalence was $10.6\%$
                      (n = 266), with $6.5\%$ HR-HPV positive (n = 165), $1.5\%$
                      'moderate' risk type (n = 38) and $3.3\%$ LR-HPV type (n =
                      84) positive. $8.9\%$ had a single infection (n = 225) and
                      $1.6\%$ had multiple types (n = 41). The most common HR-HPV
                      types were 16, 56, 52 and 31 and LR-HPV 90 and 42. Of 187
                      HR-HPV infections detected (among 165 women), $55.1\%$ (n =
                      103) were with HPV types not covered by available bivalent
                      or quadrivalent HPV vaccines. About $23\%$ (n = 43) were of
                      types not covered by the nonavalent vaccine (HPV 35, 39, 51,
                      56, 59). The HR and LR-HPV prevalence were highest in the
                      age group 30-34 years (HR $9.8\%,$ 'moderate' risk $3.0\%$
                      and LR $5.6\%),$ decreasing with increasing age. HR-HPV
                      prevalence in women with normal cytology was $5.5\%.$ In
                      women with a high-grade squamous intraepithelial lesion
                      (HSIL), prevalence was $66.7\%.$ Women currently not living
                      with a partner and current smokers had increased chances of
                      an HR-HPV infection.The overall population-based HPV
                      prevalence was relatively high. An important share of
                      prevalent HR-HPV infections constituted types not covered by
                      current HPV vaccines. With the advent of HPV screening and
                      younger vaccinated cohorts joining screening, HPV types
                      should be monitored closely, also in older women who were
                      not eligible for HPV vaccination.},
      keywords     = {Humans / Female / Papillomavirus Infections: epidemiology /
                      Papillomavirus Infections: virology / Germany: epidemiology
                      / Adult / Prevalence / Middle Aged / Papillomaviridae:
                      genetics / Papillomaviridae: classification /
                      Papillomaviridae: isolation $\&$ purification / Prospective
                      Studies / Risk Factors / Aged / Age Factors / Uterine
                      Cervical Neoplasms: epidemiology / Uterine Cervical
                      Neoplasms: virology / Genotype / Human Papillomavirus
                      Viruses / Cervical cancer screening (Other) / Germany
                      (Other) / Human papillomavirus (Other) / Prevalence (Other)
                      / Risk factors (Other)},
      cin          = {C120},
      ddc          = {610},
      cid          = {I:(DE-He78)C120-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39300354},
      doi          = {10.1186/s12879-024-09827-7},
      url          = {https://inrepo02.dkfz.de/record/293348},
}