High Prevalence of Human Papillomavirus Type 58 in Chinese Women With Cervical Cancer and Precancerous Lesions Paul K.S. Chan, 1 * Wai-Hon Li, 2 May Y.M. Chan, 2 Wei-Ling Ma, 2 Jo L.K. Cheung, 1 and Augustine F. Cheng 1 1 Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong 2 Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Kowloon, Hong Kong The prevalence of human papillomavirus (HPV) among 332 Hong Kong Chinese women with ab- normal Papanicolaou smears were determined by polymerase chain reaction and restriction fragment length polymorphism analysis. The overall HPV positive rate was 44.3% with 18.6% (16/86) for normal/inflamed cervices, 36.4% (32/ 88) for condyloma, 64.7% (33/51) for cervical in- traepithelial neoplasia grade 1 (CIN 1), 37.9% (11/29) for CIN 2, 68.3 (41/60) for CIN 3, and 77.8% (14/18) for carcinoma. Double HPV infec- tion was detected in 17 of the 147 positive samples, with a significantly higher proportion in patients with normal or inflamed cervices than those with CIN or carcinoma (31.3% vs 10.5%, P = .029). The six most commonly iden- tified genotypes were HPV 16 (33.3%), HPV 58 (23.8%), HPV 11, 18, 31 (8.8% each), and HPV 33 (6.8%). The worldwide uncommon genotype HPV 58 was found to be the second most com- mon genotype detected in patients with cervical carcinoma (6 of 18 patients). HPV 58 infection showed a significant association with CIN/ carcinoma (odds ratio [OR] = 3.98; 95% confi- dence interval [CI] = 1.22–14.35) and a significant trend of increase in prevalence with increasing severity of cervical lesion ( 2 = 5.84; P = .016). Among Hong Kong Chinese women with abnor- mal cervical cytology, the detection of HPV 58 carried a positive predictive value of 68.6% for a cervical lesion of CIN 1 or higher severity. The high prevalence of HPV 58 among Chinese women, particularly in patients with carcinoma, has an implication on the design of HPV detec- tion methods and the development of vaccines. J. Med. Virol. 59:232–238, 1999. © 1999 Wiley-Liss, Inc. KEY WORDS: HPV prevalence; HPV geno- types; polymerase chain reac- tion; restriction fragment length polymorphism; multiple infection; cervical intraepitheli- al neoplasia INTRODUCTION Papillomaviruses are a heterogeneous group of DNA viruses, which occur predominantly in squamous epi- thelium causing hyperplastic, papillomatous, and ver- rucous squamous epithelial lesions in humans and in a wide range of animals. To date, more than 85 human papillomavirus (HPV) types have been identified, of which at least 28 types have been found in female geni- tal tract infections [Munoz and Bosch 1992; De Villiers 1994; Van Ranst et al., 1996]. Strong evidence accumu- lated from epidemiological surveys, clinical observa- tions, and molecular biological studies has implicated an etiologic role for HPV infection in the development of cervical intraepithelial neoplasia (CIN) and cervical cancer [Herrington, 1994, 1995]. HPVs have been cat- egorized into “high-risk” (HPVs 16, 18, 45, and 56), “intermediate-risk” (HPVs 31, 33, 35 51, 52, and 58), and “low-risk” (HPVs 6, 11, 42, 43, and 44) groups based on their relative risks for the occurrence of a high-grade cervical lesion and an invasive cancer [Lorincz et al., 1992]. Although cervical cancer is relatively common in the People’s Republic of China [Pao et al., 1993], little re- search has been published in the West regarding the prevalence of HPV infection in Chinese women. Stud- ies from Central and South America, Europe, Africa, and Southeast Asia have consistently showed a high prevalence (75–100%) of HPV infection among women with invasive cervical cancer [Bosch et al., 1995]. In contrast, Pao et al. [1994] found evidence of HPV in- Grant sponsor: Queen Elizabeth Hospital; Grant number: R95- 2-3. *Correspondence to: Dr. Paul K. S. Chan, Department of Mi- crobiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. E-mail: paulkschan@cuhk.edu.hk Accepted 17 December 1998 Journal of Medical Virology 59:232–238 (1999) © 1999 WILEY-LISS, INC.