Human Papilloma Virus Distribution Across the African Diaspora

Abstract

PURPOSE Understanding the distribution of human papilloma virus (HPV) subtypes in limited-resource settings is imperative for cancer prevention strategies in these regions. The objective of our study is to compare the prevalence of cervical HPV genotypes in women across the African diaspora. METHODS This study was approved by the African Caribbean Consortium (AC3). Six member institutions (Benin, Ethiopia, The Bahamas, Tobago, Curacao, and Jamaica) provided independently collected HPV data. Prevalence comparisons across for each nation were performed followed by an assessment of anticipated 9-valent vaccine coverage. Chi-square or Fisher's exact tests were used with significance at P < .05. RESULTS One thousand three hundred fifty high-risk (HR) and 584 low-risk (LR) HPV subtypes were identified in the entire cohort. The most common HR HPV subtype was HPV 16 (17.9%) of infections. The distribution of HR and LR subtypes varied by country. The proportion of HR-HPV subtypes covered by the current 9-valent vaccine was lower in African countries compared with the Caribbean countries (47.9% v 67.9%; P < .01). No significant difference was seen for LR subtypes (8.1% African continent v 5.2% Caribbean; P = .20). Marked variation in the proportion of infections covered by the 9-valent vaccine persisted in individual countries. CONCLUSION Significant variations in HPV prevalence were identified among African and Afro-Caribbean women. A large number of women in these regions are potentially uncovered by current vaccination formulation, particularly low-risk HPV infections.

Point-of-Care Molecular Test for the Detection of 14 High-Risk Genotypes of Human Papillomavirus in a Single Tube

“…31,32 For example, type 66 is the most common high-risk genotype in Benin. 5 Excluding high-risk strains from our study's test would potentially miss significant infections and reduce a physician's capacity to screen for cervical cancer. For this reason, we continued to test for all 14 strains.…”

“…There has been debate on which strains to consider as high-risk . Some studies have shown that types 39, 59, 66, and 68 have a low probability of developing CIN3 or greater in comparison to types 16 and 18. − However, each of these strains has a different disease burden in different countries and subsequently have higher rates of strain-specific cancer. , For example, type 66 is the most common high-risk genotype in Benin . Excluding high-risk strains from our study’s test would potentially miss significant infections and reduce a physician’s capacity to screen for cervical cancer.…”

“…Over 70% of all cervical cancers are attributed to types 16 and 18 in the United States, with other countries having different hrHPV strain distributions. 4,5 The virus enters the basal epithelial cells through microlesions usually caused by trauma in a region called the cervical transformation zone, where columnar cells differentiate into squamous cells. 6 For the past 50 years, the primary screening method has focused on cervical testing, primarily the Papanicolaou (Pap) test.…”

“…The hrHPV types, which cause cervical lesions, comprise 14 types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Over 70% of all cervical cancers are attributed to types 16 and 18 in the United States, with other countries having different hrHPV strain distributions. , The virus enters the basal epithelial cells through microlesions usually caused by trauma in a region called the cervical transformation zone, where columnar cells differentiate into squamous cells …”

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

“…Specifically, HR-HPV types from cervical samples in Ethiopia were reported to be diverse [23,26,27,30,31,50]. This implies that HPV genotype distribution is diverse at different places and periods even within the same population [54]. Similarly, the distribution of HR-HPVs among women in other African countries was reported to heterogeneous [25,49,52,55,56].…”