Cervical human papillomavirus and HIV infection in women of child-bearing age in Abidjan, Côte d’Ivoire, 2010

Abstract

Background: We sought to document the association of Human immunodeficiency Virus (HIV) infection and immunodeficiency with oncogenic Human Papillomavirus (HPV) infection in women with no cervical neoplastic lesions identified through a cervical cancer screening programme in Côte d'Ivoire. Methods: A consecutive sample of women stratified on their HIV status and attending the national blood donor clinic or the closest HIV clinic was recruited during a cervical cancer screening programme based on the visual inspection. Diagnosis of HPV infection and genotype identification were based on the Linear Array; HPV test. Results: A total of 445 (254 HIV-positive and 191 HIV-negative) women were included. The prevalence of oncogenic HPV infection was 53.9% (95% confidence interval (CI) 47.9–59.9) in HIV-positive women and 33.7% (95% CI 27.1–40.3) in HIV-negative women (odds ratio (OR)=2.3 (95% CI 1.5–3.3)). In multivariate analysis, HIV-positive women with a CD4 count <200 cells mm 3 or between 200 and 499 cells mm 3 were more likely to harbour an oncogenic HPV compared with women with a CD4 count ⩾500 cells mm 3 with OR of 2.8 (95% CI 1.1–8.1) and 1.7 (95% CI 1.0–2.9), respectively. Conclusion: A high prevalence of oncogenic HPV was found in women with no cervical neoplastic lesions, especially in HIV-positive women. Despite antiretroviral use, immunodeficiency was a main determinant of the presence of oncogenic HPV.

The Effect of Cryotherapy on Human Papillomavirus Clearance Among HIV-Positive Women in Lusaka, Zambia

“…This test uses biotinylated PGMY primers to amplify a 450-bp fragment within the polymorphic L1 region of the HPV genome and allows for the identification of 37 anogenital HPV types [6, 11, 16, 18, 26, 31, 33, 35, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 58, 59, 61, 62, 64, 66, 67, 68, 69, 70, 71, 72, 73 (MM9), 81, 82 (MM4), 83 (MM7), 84 (MM8), IS39, and CP6108]. The HPV52 detected by the LA test could represent concurrently present HPV33, HPV35 and HPV58, because the probe for HPV52 is a mixed probe that cross-reacts with these 3 types [16]. The LA HPV test also amplifies a 265-bp region of the human β -globin gene that serves as an internal control for DNA extraction and amplification.…”

Prevalence of HPV Among HIV-Negative Women of Child-Bearing Age in Lomé, Togo

“…Indeed, in a meta-analysis of 1 million women with normal cytological findings published in 2010, Bruni et al reported a prevalence of 24% in sub-Saharan Africa [17]. This prevalence is also low compared with the prevalence found in other West African countries, with 33.2% in Benin, 24.3% in Burkina Faso and 50.3% in Côte d'Ivoire [5,9,18]. This difference could be explained by many factors such as the laboratory technique used, the age and HIV status of the population.…”

“…Since no data on HPV infection were available in the general population in Togo, the sample size calculation was based on the following assumptions: an expected prevalence of HPV infection of 30% based on estimates in a population of HIV-negative women of child-bearing age of 33% in Côte d'Ivoire [5], country of West Africa, with a precision of 6%, a significance level set at 5% and a non-response rate of 10%; the minimum sample size was estimated at 246 participants.…”

“…This percentage rises to 90% for HPV6/11/16/18/31/33/45/52/58 [3]. Main factors associated with HPV are: multiple sexual partners, early sexual activity, prolonged oral contraception use, smoking, poor socio-economic conditions, associated sexually transmitted infections and HIV infection [3][4][5].…”

“…The burden of cervical cancer and HPV infection can be reduced and control strategies rely on HPV vaccination and early detection of benign or precancerous cervical lesions [5]. To date, three HPV vaccines are widely marketed internationally: Cervarix R (GlaxoSmithKline), Gardasil R (Merck), and Gardasil-9 R (Merck), which protect against HPV 16/18, HPV 6/11/16/18 and HPV-6/11/16/18/31/33/45/52/58, respectively [6,7].…”