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Age-specific HPV seroprevalence among young females in The Netherlands
  1. Merlijn Kramer1,
  2. Liesbeth Mollema1,
  3. Gaby Smits2,
  4. Hein Boot2,
  5. Hester de Melker1,
  6. Fiona van der Klis2
  1. 1Department of Epidemiology and Surveillance, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  2. 2Laboratory for Infectious Diseases and Perinatal Screening, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  1. Correspondence to Ms Merlijn Kramer, National Institute for Public Health and the Environment, Center for Infectious Disease Control/Epidemiology and surveillance, Postbox 1 (internal postbox 75), 3720 BA Bilthoven, The Netherlands; merlijn.kramer{at}


Objectives To obtain insight into the age-specific seroprevalence for human papillomavirus (HPV) 6, 11, 16 and 18 among females before introduction of HPV vaccination in The Netherlands.

Methods In a population-based study in The Netherlands, 637 sera of 11–26-year-old females were tested for HPV6/11/16/18 antibodies. Sera were tested using a competitive Luminex assay with neutralising monoclonal antibodies specific for each serotype. Associations between HPV seropositivity, demographics, and sexual behaviour were studied with logistic regression. Seroprevalences were standardised for age and urbanisation degree to the general female population in The Netherlands.

Results The overall prevalence of antibodies against HPV6/11/16/18 was 7.9%. 4.3% had antibodies against HPV types 6/11, and 4.4% had antibodies against HPV types 16/18. HPV seropositivity significantly increased with age (OR 1.2; 95% CI 1.1 to 1.4), starting at the age of 16 years (median age of sexual debut in The Netherlands). A former diagnosis with sexually transmitted infections was also significantly associated with HPV seropositivity (OR 6.3; 95% CI 2.2 to 17.9).

Conclusions In addition to 12-year-old girls who are targeted for routine HPV vaccination, also girls up to 16 years are likely to benefit substantially from HPV16/18 vaccination. Testing for the presence of HPV antibodies in females after introduction of vaccination makes it possible to monitor the impact of immunisation at the population level.

  • HPV
  • seroprevalence
  • women
  • epidemiology
  • sexual behaviour
  • epidemiology

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Medical Ethics Testing Committee of the foundation of therapeutic evaluation of medicines (METC-STEG) in Almere, The Netherlands.

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