Prevalence of Human Papillomavirus Infection in Women in South Korea -Incidence of Positive HPV DNA and anti-VLPs in Residents of Busan City-

한국인 일반 여성의 HPV 감염 유병율 -부산지역 일반 여성에서의 HPV DNA 및 항 VLPs 항체 양성 빈도 -

  • Hong, Sook-Hee (Department of Pathology, Dong-A University College of Medicine) ;
  • Lee, Duk-Hee (Department of Preventive Medicine, Kyung Pook National University School of Medicine) ;
  • Shin, Hai-Rim (Division of Cancer Epidemiology and Control, National Cancer Center Research Institute)
  • 홍숙희 (동아대학교 의과대학 병리학교실) ;
  • 이덕희 (경북대학교 의과대학 예방의학교실) ;
  • 신해림 (국립암센터 암역학관리연구부)
  • Published : 2004.05.30


To investigate a population-based survey of the prevalence of human papillomavirus (HPV) infection in South Korea, we performed Papanicolaou smears and tests for HPV DNA and anti-HPV antibody detection in 909 sexually active general women (age range; 20-74 years, median 44 years) who were randomly selected residents from S district of Busan City. The presence of DNA of 36 different HPV types was detected by means of a GP 5+/6+ primer-mediated PCR enzyme immunoassay in cervical exfoliated cells, and IgG antibodies against L1 virus-like particles (anti-VLPs) of 5 HPV types 16, 18, 31, 33, and 58 were tested by means of enzyme linked immunoassay. The incidence of cytologic abnormality was 5.2% in Pap smear. The positive rate of HPV DNA was 10.4%, high in young women younger than 35 years old and proportionally increased according to the cytologic grades. The most often found HPV type was HPV 70, followed by HPV 16 and 33, and high-risk HPV types were more frequent in women younger than 35 years old. The most common HPV type in abnormal cytologic smears was HPV 16, followed by HPV 58 and 66. Anti-VLPs was positive in 19.7% and the frequent anti-VLPs type was against HPV 18, followed by HPV 31 and 16. The concordance between the markers for each specific HPV type was noted in 10 women and HPV 16 was the most frequent one. The incidence of multiple HPV infection was 18.9% and that of multiple anti-VLPs antibodies was 31%. Among 103 self-reported virgins, 4.9% had anti-VLP antibodies.



  1. Ho GYF, Bierman R, Beardsley L, Chang CJ, Burk RD. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med 1998;338:423-8
  2. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1977;102:3-8
  3. Bosch FX, Lorincz A, Munoz N, Meijier CJLM, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002;55:244-65
  4. Harro CD, Pang YY, Roden RB, et al. Safety and immunogenicity trial in adult volunteers of a human papillomavirus 16 L1 virus-like particles vaccine. J Natl Cancer Inst 2001;93:284-92
  5. Evans TG, Bonnez W, Rose RC, et al. Phase I study of a recombinant viruslike particle vaccine against human papillomavirus type 11 in healthy adult volunteers. J Infect Dis 2001;183:1485-93
  6. Hwang T. Detection and typing of human papillomavirus DNA by PCR using consensus primers in various cervical lesions of Korean women. J Korean Med Sci 1999;14:593-9
  7. Jacobs MV, Roda Husman AM, van den Brule AJ, Snijders PJ, Meijer CJ, Walboomers JM. Group-specific diffe-rentiation between high- and low-risk human papillomavirus genotypes by general primer-mediated PCR and two cocktails of oligonucleotide probes. J Clin Microbial 1995;33:901-5
  8. Combita AL, Bravo MM, Touze A, Orozco O, Coursaget P. Serologic response to human oncogenic papillomavirus types 16, 18, 31, 33, 39, 58 and 59 viruslike particles in Colombian women with invasive cervical cancer. Int J Cancer 2002;97:796-803
  9. Sukvirach S, Smith JS, Kesararat W, et al. Population-based human papillomavirus prevalence in Lampang and Songkla, Thailand. 19th International Papillomavirus Conference 2001;P-243:149
  10. Pham TH, Nguyen TH, Herrero R, et al. Human papillomavirus infection among women in South and North Vietnam. Br J Cancer 2003;104:213-20
  11. Herrero R, Hildesheim A, Bratti C, et al. Population-based study of human papillomavirus infection and cervical neoplasia in rural Costa Rica. J Natl Cancer Inst 2000;92:464-74
  12. Lazcano-Ponce E, Herrero R, MuDoz N, et al. Epidemiology of HPV infection among Mexican women with normal cervical cytology. Int J Cancer 2001;91:412-20<412::AID-IJC1071>3.0.CO;2-M
  13. Jacobs MV, Walboomers JM, Snijders PJ, et al. Distribution of 37 mucosotropic HPV types in women with cytologically normal cervical smears: the age-related patterns for high-risk and low-risk types. Int J Cancer 2002;87:221-7
  14. Molano M, Posso H, Weiderpass E, van den Brule AJ, Ronderos M, Franceschi S. Prevalence and determinants of HPV infection among Colombian women with normal cytology. Br J Cancer 2002;87:324-33
  15. Shin HR, Lee DH. Cancer incidence in Busan, Korea, 1996-1997. Busan: Association of Busan Cancer Registry, 2000
  16. Stoler MH. Advances in cervical screening technology. Mod Pathol 2000;13:275-84
  17. Kulasingam SK, Hughes JP, Kiviat NB, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities. Comparison of sensitivity, specificity, and frequency of referral. JAMA 2002;288:1749-57
  18. Castle PE, Wacholder S, Sherman ME, et al. Absolute risk of a subsequent abnormal pap among oncogenic human papillomavirus DNA-positive, cytologically negative women. Cancer 2002;95:2145-51
  19. Rosendaal L, Walboomers JMM, van der Linden JC, et al. PCR-based high-risk HPV test in cervical cancer screening gives objective risk assessment of women with cytomor-phologically normal cervical smears. Int J Cancer 1996;68:766-9<766::AID-IJC13>3.0.CO;2-Z
  20. Clifford GM, Smith JS, Plummer M, Munoz N, Franceschi S. Human papillomavirus types in invasive cancer worldwide: a meta-analysis. Br J Cancer 2003;88:63-73
  21. Schlecht NF. Kulaga S, Robitaille J, et al. Persistent human papillomavirus infection as a predictor of cervical intrae-pithelial neoplasia. JAMA 2002;286:3106-14
  22. Woodman CB, Collins S, Winter H, et al. Natural history of cervical papillomavirus infection in young women: a longitudinal cohort study. Lancet 2002;357: 1831-6
  23. Touze A, de Sanjose S, Coursaget P, et al. Prevalence of anti-human rapillomavirus type 16, 18, 31, and 58 virus-like particles in women in the general population and in prostitutes. J Clin Microbial 2001;39:4344-8
  24. Carer JJ, Koutsky LA, Hughes JP, et al. Comparison of human papillomavirus types 16, 18, and 6 capsid antibody response following incident infection. J Infect Dis 2000;181:1911-9
  25. Bosch FX, Rohan T, Schneider A, et al. Papillomavirus research update: highlights of the Barcelona HPV 2000 international papillomavirus conference. J Clin Pathol 2001;54:163-75
  26. de Gruijl TD, Bontkes HJ, Walboomers JMM, et al. Immunoglobulin G responses against human papillomavirus type 16 virus-like particles in a prospective nonintervention cohort study of women with cervical intraepithelial neoplasia. J Natl Cancer Inst 1997;89:630-8