Epidemiology of cervical human papillomavirus (HPV) infection and squamous intraepithelial lesions (SIL) among a cohort of HIV-infected and uninfected Ghanaian women

Abstract

BackgroundThere is limited data in Ghana on the epidemiology of HPV and cervical neoplasia and their associations with HIV. This study aimed to compare among HIV-1 seropositive and HIV-seronegative Ghanaian women: (1) the prevalence, genotype distribution and risk factors associated with cervical HPV infection; and (2) the prevalence and risk factors associated with abnormal cervical cytology.MethodsA comparative frequency-matched study was conducted in a systematic sample of women aged ≥18 years attending HIV and general outpatient clinics in Cape Coast Teaching Hospital, Ghana. Participants were interviewed and cervical samples collected for HPV genotyping (Seegene Anyplex-II HPV28) and cytological testing.ResultsOverall, 333 women were recruited, 163 HIV-1 seropositive and 170 HIV-seronegative women of mean age 43.8 years (SD ±9.4)) and 44.3 years (SD ±12.8), respectively. The prevalence of 14 high-risk (hr) HPV genotypes was higher among HIV-1 seropositive women (65.6% vs. 30.2%, P < 0.0001), as was proportion with multiple hr.-HPV infections (60.6% vs. 21.3%, P < 0.0001). HPV35 was the most prevalent hr.-HPV genotype in both groups (11.9% and 5.3%). The main factors associated with hr.-HPV infection were age for HIV-positive women and circumcision status of main sexual partner for both HIV-negative and positive women.Abnormal cervical cytology prevalence was higher among HIV-1 seropositive women (any SIL: 14.1% vs. 1.2%, P < 0.0001; low-grade SIL [LSIL]: 4.9% vs. 0.6%, P = 0.02; high-grade SIL: 1.8% vs. 0%, P = 0.07). Among HIV-1 seropositive women, number of pregnancies and CD4+ cell count were associated with LSIL+ cytology. There was strong association between LSIL+ abnormalities and HPV35 (aOR = 4.7, 95%CI: 1.3–17.7, P = 0.02).ConclusionsHIV-1 infected women bear significant burden of HPV infection and related disease. Prevention and screening programmes should be specifically deployed for this population in Ghana.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3682-x) contains supplementary material, which is available to authorized users.

Oncogenic human papillomavirus infection and genotypes characterization among sexually active women in Tenkodogo at Burkina Faso, West Africa

“…Indeed, the overall prevalence of 34.4% carriage of HR-HPV in these women was close to that of 38.3% in Burkina Faso [5] , 35.0% in England [9] , 33.8% in Costa Rica [10] and 33.2% in Benin [11] . On the other hand, it was lower than those of 75.0% in Ghana [12] , 74.0% in Tanzania [13] and 54.0% in South Africa [14] , 41.5% in Burkina Faso [7] obtained from studies of younger populations with a mean age of less than 30 years while that of our study was 35.5 ± 9.5 years.…”

“…Among women recruited in Tenkodogo, HPV genotypes 16 and 18 covered by currently vaccines available in Burkina Faso, accounted for 4.1% and 1.4% respectively. The prevalence of HPV18 obtained is lower than that of 5.5% in Great Britain [2] , 10,6% in Ghana [12] , 14.8% in Bobo-Dioulasso [6] , 14.3% [8] and 5.1% [7] in Ouagadougou. The results of these studies thus show a regional difference in the distribution of HPV 18.…”

Awareness of Cancer Risk Factors and Its Signs and Symptoms in Northern Tanzania: a Cross-Sectional Survey in the General Population and in People Living with HIV

“…When cancer symptoms are noticed, knowledge of the importance of early detection can be lacking [9][10][11]. Cancer awareness is important overall, and especially in high-risk individuals such as people living with HIV/AIDS (PLHIV), a prevalent group in many SSA settings with raised risks of several cancers [12][13][14][15][16].…”

Prevalence and Factors Associated with Abnormal Cervical Cell among the Hmong and Mien Hill Tribe Women in Pha Yao Province, Thailand

“…Whereas several studies [25][26][27] reported that women's number of partners and history of STIs were associated with cervical cancer among the women in South Africa. However, the study of Obiri-Yeboah 28 reported that age of women and circumcision status of main sexual partner were associated with cervical cancer, but no association was found with number of partners.…”