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Opportunity for catch-up HPV vaccination in young women after first delivery
  1. Cristina Helena Rama1,2,
  2. Luisa L Villa3,
  3. Sonia Pagliusi4,
  4. Maria A Andreoli3,
  5. Maria C Costa3,
  6. Patricia Thomann5,
  7. Venancio A F Alves2,
  8. Adhemar Longatto-Filho6,7,
  9. Jose Eluf-Neto2
  1. 1Hospital Maternidade Leonor Mendes de Barros, São Paulo, Brazil
  2. 2University of São Paulo School of Medicine, São Paulo, Brazil
  3. 3Ludwig Institute for Cancer Research, São Paulo, Brazil
  4. 4Ludwig Institute for Cancer Research, Lausanne, Switzerland
  5. 5Qiagen do Brasil, São Paulo, Brazil
  6. 6Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
  7. 7Pathology Division, Adolfo Lutz Institute
  1. Correspondence to Cristina Helena Rama, Hospital Maternidade Leonor Mendes de Barros, Av Celso Garcia, 2477, 03015-000 Belenzinho São Paulo-SP, Brazil; crisrama{at}


Background Early age at first delivery has been identified as a risk factor for high-risk HPV-type infection and cervical cancer development.

Methods A cross-sectional study was carried out in a large public maternity hospital in São Paulo, Brazil. During June 2006 to February 2007, 301 women aged 15–24 years who gave birth to their first child were recruited between 43 and 60 days after delivery. Detection of HPV DNA in cervical specimens was performed using a standardised PCR protocol with PGMY09/11 primers. The association of selected factors with HPV infection was assessed by using a Generalised Linear Model.

Results HPV DNA was detected in 58.5% (95% CI 52.7% to 64.0%) of the enrolled young women. The most common types of HPV found were: HPV16, HPV51, HPV52, HPV58 and HPV71. The overall prevalence of HPV types targeted by the HPV prophylactic vaccines was: HPV 16‐12.0%, HPV 18‐ 2.3% and HPV 6 and 11 4.3%. In the multivariate analysis, only age (inversely, p for trend=0.02) and smoking habits were independently associated with HPV infection.

Conclusions The findings show that these young primiparous women had high cervical HPV prevalence, suggesting that this is a high-risk group for cervical cancer development. Nevertheless, 17.3% were positive for any of the four HPV types included in HPV vaccines (HPV6, 11, 16 or 18), with 13.3% positive for HPV 16 or 18 and only 1.0% having both vaccine related-oncogenic HPV types. Thus, young primiparous women could benefit from catch-up HPV vaccination programmes.

  • Cervical cancer
  • immunisation
  • pregnancy
  • sexually transmitted disease
  • adolescents
  • papillomavirus infections
  • postpartum period

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  • Funding This study was supported by a research grant from Department of Immunisation, Vaccines and Biologicals, World Health Organization (ref: V20-181-13).

  • Competing interests Luisa Lina Villa is a consultant and speaker for the Quadrivalent HPV Vaccine of Merck Sharp & Dohme. José Eluf-Neto has served as a consultant to GlaxoSmithKline in 2006. The others authors have no potential conflicts of interest to disclose.

  • Ethics approval The study protocol was submitted and approved by the research ethics committees of the Hospital Maternidade Leonor Mendes de Barros, the Ludwig Institute for Cancer Research in Sao Paulo and the National Ethical Committee - CONEP (number 188/2006).

  • Provenance and peer review Not commissioned; externally peer reviewed.