HPV Infection and Cervical Screening in Socially Isolated Indigenous Women Inhabitants of the Amazonian Rainforest

Abstract

ObjectiveIndigenous women from the Amazon regions have some of the highest rates of cervical cancer in the world. This study evaluated cervical cytology and human papillomavirus (HPV) in native women that differ by lifestyle and interaction with western society. Yanomami women are isolated deep in the Amazon with a hunter/gatherer lifestyle. Macuxi and Wapishana women live in proximity to western society.MethodsTo select a representative group of women from each district, random cluster sampling was used, considering each registered village as a cluster. Cervical samples were collected for cytology and HPV detection and typing by PCR amplification and next generation sequencing. The study was approved by the National IRB and by tribal leaders.Results664 native women were enrolled from 13 indigenous villages (76% participation rate). Yanomami women had higher rates of abnormal cytology (5.1% vs. 1.8%, p = 0.04) and prevalent HR-HPV (34.1% vs. 19.2%, p<0.001). Yanomami women >35y of age were significantly more likely to have HR-HPV, whereas women ≤35y did not significantly differ between groups. Prevalence of HPV was significantly different amongst geographically clustered Yanomami women (p<0.004). The most prevalent HPV types in the entire group were HPV31 (8.7%), HPV16 (5.9%) and HPV18 (4.4%).ConclusionIsolated endogenous Yanomami women were more likely to be HPV+ and rates increased with age. Study of HPV in isolated hunter-gather peoples suggests that long-term persistence is a characteristic of prehistoric humans and patterns reflecting decreased prevalence with age in western society represents recent change. These studies have implications for cervical cancer prevention and viral-host relationships.

Human papillomavirus genotypes 68 and 58 are the most prevalent genotypes in women from quilombo communities in the state of Maranhão, Brazil

“…15 In a recent study involving indigenous populations of the Amazonian Rainforest, in Brazil, the overall frequency of HPV was 39.7%, but in women from the Yanomami District it reached 45.9%, whereas in women from the Eastern Indigenous District HPV infection was found in 34.5% of women. 16 Of the clinical and behavioral variables analyzed and their association with cytological abnormalities, HPV infection was the only significant factor. Despite the low number of women included in the study, which could have influenced some of the conclusions, individuals living in quilombo communities are geographically isolated and display conservative habits.…”

“…5,18,19 The same pattern of genotype frequency has also been observed in women from indigenous isolated communities in South American countries, such as Argentina, Brazil, and Paraguay. 15,16,20,21 Although the number of samples was low, it can be hypothesized that one of the reasons for the difference in the genotype profile is that individuals living in quilombos maintain conservative sexual habits, without having sex with people in the general population. Thus, the dynamics in the circulation of HPV types might have been influenced by their sexual isolation over the years.…”

Comparison of three human papillomavirus DNA detection methods: Next generation sequencing, multiplex‐PCR and nested‐PCR followed by Sanger based sequencing

“…In the original study [Fonseca et al, ], the participants underwent a gynecological examination including speculum examination with collection of cervical cells, using a cervical brush, which was inserted into cervical channel (1 to 1,5 cm deep) and twisted three times. The samples were eluted into specimen transport medium (STM ® ; Qiagen, CA) and DNA was isolated using QIAamp DNA ® kits (Qiagen, CA) following the recommended protocol.…”

Distribution and attribution of high-risk human papillomavirus genotypes in cervical precancerous lesions in China

“…The HR-HPV prevalence and distribution vary across ethnic groups, regions, nations, and histological types. [7][8][9][10][11] This study investigated the prevalence, distribution, and attribution of HR-HPV genotypes among women with cervical precancerous lesions in China to develop an HR-HPV-based screening approach and determine the spectrum of HR-HPV genotypes to be covered. 12,13 Materials and methods…”