Seroprevalence of Human Papillomavirus Types 6, 11, 16, and 18 in the United States: National Health and Nutrition Examination Survey 2003-2004

Background. Human papillomavirus (HPV) seroprevalence data can help define the epidemiology of this common sexually transmitted pathogen. Methods. We determined the seroprevalence of HPV types 6, 11, 16, and 18 (HPV types in the quadrivalent vaccine) among 4303 persons aged 14-59 years who participated in the National Health and Nutrition Examination Survey 2003-2004. Results. The seroprevalences of HPV types 6, 11, 16, and 18 among female subjects were 17.0%, 7.1%, 15.6%, and 6.5%, respectively. Among males, the seroprevalences were lower for each type, with 6.3% observed for HPV-6, 2.0% for HPV-11, 5.1% for HPV-16, and 1.5% for HPV-18 (P < .001 for all comparisons). For any HPV vaccine type, the seroprevalence was 32.5% among females and 12.2% among males; the seroprevalence of any HPV vaccine type increased with age, reaching 42.0% among women aged 30-39 years and 18.0% among men aged 50-59 years. Antibodies to all 4 vaccine types were detected in 0.4% of females and 0% of males. Non-Hispanic blacks had a higher seroprevalence of any HPV vaccine type than that observed for non-Hispanic whites or Mexican Americans. Age and lifetime number of sex partners were factors independently associated with seroprevalence of any HPV vaccine type among both females and males, and poverty level was also a factor among females. Conclusions. This is the first population-based seroprevalence study in the United States of all 4 HPV types targeted by the quadrivalent vaccine, and its findings can inform vaccine policy.