Geographic variations of human papilloma virus infection and their possible impact on the effectiveness of the vaccination programme.

Greece is one of the first countries of the European Union to introduce a human papilloma virus (HPV) vaccine in its national vaccination programme. Geographical variations in the prevalence of the different HPV types have been demonstrated. The aim of this preliminary case control study was to investigate HPV infection in women with low- and high-grade squamous intraepithelial lesions (SILs) from two different geographical areas of Greece; Central Greece and Crete. Seventy-five cervical specimens were collected from women with SILs from Crete and Central Greece. HPV detection and typing were performed by using polymerase chain reaction (PCR) techniques. HPV-18 was detected more frequently in Crete than in the Central Greece samples (29.7 vs 13.1%). HPV-16 was predominant in Central Greece (34.2%), while in Crete it was detected in 23% of the studied women. Non-16/-18 HPV types were detected in 45.9% of the women from Crete and 52.6% of the women from Central Greece. No relationship was observed between the geographical distribution of HPV and the presence of K-ras or B-raf point mutations in either group. Our pre-vaccination data indicate a high prevalence of HPV-18 in Crete. A trend for difference was observed in the rates of non-HPV-16/-18 women between the two areas. A large epidemiological study is required to investigate the prevalence of the different HPV types to further investigate the effectiveness of HPV vaccination in the Greek population.