High-risk HPV genotypes in Zimbabwean women with cervical cancer: Comparative analyses between HIV-negative and HIV-positive women

Abstract

Background High-risk human papillomavirus HPV (HR-HPV) modifies cervical cancer risk in people living with HIV, yet African populations are under-represented. We aimed to compare the frequency, multiplicity and consanguinity of HR-HPVs in HIV-negative and HIV-positive Zimbabwean women. Methods This was a cross-sectional study consisting of women with histologically confirmed cervical cancer attending Parirenyatwa Group of Hospitals in Harare, Zimbabwe. Information on HIV status was also collected for comparative analysis. Genomic DNA was extracted from 258 formalin fixed paraffin embedded tumour tissue samples, and analysed for 14 HR-HPV genotypes. Data was analysed using Graphpad Prism and STATA. Results Forty-five percent of the cohort was HIV-positive, with a median age of 51 (IQR = 42–62) years. HR-HPV positivity was detected in 96% of biospecimens analysed. HPV16 (48%), was the most prevalent genotype, followed by HPV35 (26%), HPV18 (25%), HPV58 (11%) and HPV33 (10%), irrespective of HIV status. One third of the cohort harboured a single HPV infection, and HPV16 (41%), HPV18 (21%) and HPV35 (21%) were the most prevalent. HIV status did not influence the prevalence and rate of multiple HPV infections (p>0.05). We reported significant (p<0.05) consanguinity of HPV16/18 (OR = 0.3; 95% CI = 0.1–0.9), HPV16/33 (OR = 0.3; 95% CI = 0.1–1.0), HPV16/35 (OR = 3.3; 95% CI = 2.0–6.0), HPV35/51 (OR = 6.0; 95%CI = 1.8–15.0); HPV39/51 (OR = 6.4; 95% CI = 1.8–15), HPV31/52 (OR = 6.2; 95% CI = 1.8–15), HPV39/56 (OR = 11 95% CI = 8–12), HPV59/68 (OR = 8.2; 95% CI = 5.3–12.4), HPV66/68 (OR = 7; 95% CI = 2.4–13.5), independent of age and HIV status. Conclusion We found that HIV does not influence the frequency, multiplicity and consanguinity of HR-HPV in cervical cancer. For the first time, we report high prevalence of HPV35 among women with confirmed cervical cancer in Zimbabwe, providing additional evidence of HPV diversity in sub-Saharan Africa. The data obtained here probes the need for larger prospective studies to further elucidate HPV diversity and possibility of selective pressure on genotypes.

Cervical human papillomavirus genotypes in a high HIV setting: A scoping review of a decade of human papillomavirus epidemiological research in Botswana

“…In general, HPV-16 remains by far the most common high-risk HPV genotype in Botswana among women with pre-cancer and cancer, in both HIV-positive and HIV-negative. The data showed are consistent with the previously published literature investigating women living with HIV (37), but cannot fully sustain the hypothesis that HIV may substantially alters the relative carcinogenic activity of less virulent high-risk HPV genotypes as reported previously worldwide, in East Africa and in Zimbabwe (37)(38)(39)(40). According to the available literature on Botswana, HPV-16 and HPV-18, that are known to be more prevalent in cervical cancer cases, seem to be lower in young women and increase with age and severity of the cervical lesions.…”

Tracking HPV Infection, Associated Cancer Development, and Recent Treatment Efforts—A Comprehensive Review

“…The aforementioned stages of replication help the virus to further replicate and avoid inflammatory responses and to persist in unnotified progression [ 22 ]. This factor is the major force behind the low clearances of viruses in women even after 6–12 months of infections [ 23 ]. HPV 16 has been found to inflict long periods of infection.…”

“…HPV-related HNSCCs are different from those that lack HPV intrusion, based on underlying oncogenic regulations, prognosis responses, and available treatment options [ 37 ]. Similarly, the concomitant HPV and squamous intra-epithelial lesions (HSILs) have been found in patients suffering from HIV, which also indicates the co-infectious nature of HPV with other viral diseases [ 23 ]. Several recent studies have elaborated the clinical reports of patients suffering from primary vulvovaginal cancer and HPV infections and have, thus, established links between HPV infection and vaginal cancer [ 38 , 39 ].…”

High-risk human papillomavirus genotype distribution among women with gynecology complaints in northwest Ethiopia

“…Of all types, about 40 are sexually transmitted [8,[11][12][13][14]. HPV16, 18,31,33,35,39,45,51,52,56,58,59 and 68 grouped under HR-HPV because of their strong association in carcinogenesis. Infection with HPV type 16 or HPV18 is associated with a higher risk of disease progression compared to other HR-HPVs causing more than 50% of all cervical cancer burdens globally [15][16][17][18].…”