Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

Abstract

Human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions (SILs) were studied in 379 high-risk women. Human papillomavirus DNA was detected in 238 of 360 (66.1%) of the beta-globin-positive cervical samples, and 467 HPV isolates belonging to 35 types were identified. Multiple (2 -7 types) HPV infections were observed in 52.9% of HPV-infected women. The most prevalent HPV types were HPV-52 (14.7%), HPV-35 (9.4%), HPV-58 (9.4%), HPV-51 (8.6%), HPV-16 (7.8%), HPV-31 (7.5%), HPV-53 (6.7%), and HPV-18 (6.4%). Human immunodeficiency virus type 1 (HIV-1) seroprevalence was 36.0%. Human papillomavirus prevalence was significantly higher in HIV-1-infected women (87 vs 54%, prevalence ratio ( Cervical cancer is the most frequent cancer of women in developing countries, particularly in sub-Saharan Africa (Parkin et al, 1999), and it is now well established that genital infection with certain types of human papillomavirus (HPV) causes virtually all cases of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) (Walboomers et al, 1999). The HPV types that infect the genital tract have been subdivided into low-risk (LR) types, which are principally found in nonmalignant lesions such as genital warts, and high-risk (HR) types, which are associated with the development of CIN and ICC. Human papillomavirus types 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and 89 are classified as LR types, whereas types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82 are classified as HR types. In addition, HPV types 26, 53, and 66 are considered as probably carcinogenic (Muñoz et al, 2003).Human papillomavirus prophylactic vaccines are now being developed and promising results have been obtained with recombinant L1 capsid protein virus-like particles (VLPs). However, the current HPV vaccines target the most prevalent high-risk HPV (HR-HPV) types worldwide, namely HPV-16 and HPV-18 (Koutsky et al, 2002;Ault et al, 2004;Brown et al, 2004;Harper et al, 2004). It has been shown that crossneutralisation induced by L1 VLPs represents less than 1% of the neutralising activity induced by the dominant conformational epitope , indicating that current HPV vaccines would be able to confer only type-specific immunity. Therefore, effectiveness of these vaccines on the prevention of cancer may be lower in populations highly affected by HR-HPV types other than HPV-16 and HPV-18. Thus, it is important to document the distribution of HPV genotypes in HPV-infected women and in women with cervical neoplasia in African countries in order to assess the potential effectiveness of a bivalent HPV-16/18 vaccine.There have been few detailed studies of HPV genotypes and their association with intraepithelial lesions or ICC in sub-Saharan Africa. Available data suggest, however, a higher prevalence and wider spectrum of oncogenic HPV types compared to studies conducted elsewhere (Castellsague et al, 2001;De Vuyst et al, 2003;Mayaud et al, 2003;Clifford et al, 2005;Wall et al, 2005). Furthermore, the high backgr...

Prevalence and distribution of HPV genotypes among HIV-infected women in Zambia

“…This finding has implications in the eventual implementation of prophylactic HPV vaccines based on HR-HPV types 16 and 18 (Steinbrook, 2006). Our results add to those reported in a recent meta-analysis of HPV types among HIVinfected women (Clifford et al, 2006) and the recent international data which indicate the increased preponderance of HPV types other than 16 or 18 among HIV-infected women (Levi et al, 2002;Bollen et al, 2006;Didelot-Rousseau et al, 2006;Luque et al, 2006). If cross-reacting immunity is not induced across viral types by existing vaccines, this will limit their efficacy in immunosuppressed women in developing countries whose dominant HR-HPV types may be other than 16 and 18.…”

“…Comparable studies using PCR-based detection of HPV in HIV-infected women have reported 12 -79% of study participants with multiple HPV types (Levi et al, 2002;Moscicki et al, 2004;Bollen et al, 2006;Didelot-Rousseau et al, 2006;Hawes et al, 2006;Luque et al, 2006). This high prevalence may reflect the immune impairment by HIV that fails to clear HPV, leading to chronic HPV infection.…”

Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria

“…24 A prevalence of 66.1% was reported in a study carried out in Burkina-Faso. 25 Similar studies also carried out in other parts of Africa showed a prevalence of as high as 97.2%. 26 These variations in figures may be attributable to the exhaustive nature of the HPV detection strategy used in the various studies especially those carried out in Asia and America.…”

HPV genotypes in women with squamous intraepithelial lesions and normal cervixes participating in a community-based microbicide study in Pretoria, South Africa

“…10 The high HIV prevalence could explain the observed HPV genotype distribution, since HIV-infected women are reported to acquire a broader spectrum of HPV genotypes other than HPV 16 or 18. [11][12][13] Most previous studies in South Africa were conducted in low HIV prevalence areas. This finding is epidemiologically important because the existing vaccine may not be as efficacious in this region of South Africa.…”