Human papillomavirus genotypes in women with invasive cervical cancer with and without human immunodeficiency virus infection in Botswana

Abstract

Cervical cancer remains a significant cause of morbidity and mortality in women worldwide and is the leading cause of cancer-related death in Botswana. It is well established that women with HIV have a higher risk of persistent HPV infection leading to cervical cancer. We assessed HPV prevalence and genotype distribution in 126 tissue specimens from confirmed invasive cervical cancer cases using Abbott real-time PCR assay. Overall, 88(69.8%) women were HIV-infected. Fifty-seven (64.8%) of the HIV-infected women had a baseline CD4 + count ≥ 350 cells/μl, and 82(93.2%) were on antiretroviral therapy at the time of cervical cancer diagnosis. The median age of HIV-infected patients was signficantly younger than that of HIV-uninfected patients (p < 0.001). HPV DNA was detected in all of 126(100%) of tissues analysed in our study. The HPV genotypes identfied included the HPV-16 (75.4%), HPV-18 (28.6%) and other high-risk (hr) HPV genotypes

Promoter Hypermethylation Analysis of Host Genes in Cervical Cancer Patients With and Without Human Immunodeficiency Virus in Botswana

“…Of 128 specimens from invasive cervical cancer patients, 77 (62.6%) were from HIV-infected women and 46 (37.4%) were from HIV-uninfected women. The HIV-infected patients were younger than their HIV-uninfected counterparts (average age of 43 vs. 61 years, respectively; P < 0.001) in patients with invasive cervical cancer (13). Among the non-cancer control group, 24 (24.0%) were HIV-uninfected, while 10 (10.0%) were HIV-infected.…”

“…All samples were selected and confirmed according to histological analysis. The demographic and clinical characteristics of patients with invasive cervical cancer have been previously described (13). However, for control specimens, age was not accessible and data on HIV status was incomplete.…”

“…Characteristics of study participants are summarized in Table 1. All available tissue samples from women with a histologically confirmed diagnosis of invasive cervical cancer from the previous study (13) were included (n = 128), while the control group (non-cancer subjects) was added (n = 100; see Table 1). All samples studied, excluding 7 (from non-cancer control group), were positive for high-risk HPV genotypes.…”

“…Women infected with HIV still have relatively high rates of HPV infection and persistence, with subsequent risk of cell transformation and progression to cervical cancer (8). A number of studies performed in Botswana suggest that HIV might influence the distribution of some HPV genotypes (9)(10)(11)(12)(13). In one study, a significant association in the prevalence of HPV-16 genotype among HIV-infected patients was reported, despite over 90% of the patients taking ART treatment at the time of cervical cancer diagnosis (13).…”

“…A number of studies performed in Botswana suggest that HIV might influence the distribution of some HPV genotypes (9)(10)(11)(12)(13). In one study, a significant association in the prevalence of HPV-16 genotype among HIV-infected patients was reported, despite over 90% of the patients taking ART treatment at the time of cervical cancer diagnosis (13). However, it is generally accepted that persistent high-risk HPV genotypes are necessary, but not always sufficient, to develop cervical cancer (6).…”