Human papillomavirus infection and cervical abnormalities in Nairobi, Kenya, an area with a high prevalence of human immunodeficiency virus infection

Abstract

Human papillomavirus (HPV) infection and cervical abnormalities, and their association with human immunodeficiency virus (HIV) infection were studied in 488 women who visited a health center in Nairobi. PCR-based HPV and cervical cytology tests were carried out on all participants, and peripheral CD4+ T cells and plasma HIV RNA were quantitated in HIV positive women. HIV were positive in 32% (155/488) of the women; 77% of these were untreated, and the others had been treated with anti-retroviral drugs within 6 months. Cervical HPV infection was detected in 17% of HIV negative and 49% of HIV positive women. Low-grade squamous intraepithelial lesions were observed in 6.9% of HIV negative and 21% of HIV positive women, while high-grade squamous intraepithelial lesions and cancer were seen in 0.6% and 5.8%, respectively. Multivariate analysis revealed that HIV and HPV infections were associated with each other. Cervical lesions were significantly associated with high-risk HPVs and with HIV infection, depending on HPV infection. HPV infection increased in accordance with lower CD4+ T cell counts and higher HIV RNA levels, and high-grade lesions were strongly associated with high-risk HPV infection and low CD4+ T cell counts. Immunosuppression as a result of HIV infection appears to be important for malignant progression in the cervix. Nationwide prevention of HIV infection and cervical cancer screening are necessary for the health of women in this area. High-risk HPV infection and low CD4+ T cell counts are the risk factors for cervical cancer.

Human papillomavirus infection induces NF-κB activation in cervical cancer: A comparison with penile cancer

“…The overall prevalence of any type of HPV in the general populations of sub-saharan Africa for females with normal cytology is 21.8% (16). yamada et al (17) reported that the overall prevalence of HPV infection in the uterine cervix associated with abnormalities was 27% in Nairobi, kenya. The prevalence of HPV-16 and/or HPV-18 among invasive cervical cancer case ranges from 43.7% in senegal to 90.2% in Ethiopia (16).…”

Prevalence and incidence of cervical intra-epithelial neoplasia among female sex workers in Korogocho, Kenya

“…9,11,12 It is also not dissimilar from reports from other African countries in the region, such as the Democratic Republic of Congo, where the prevalence of CIN among sex workers has been reported to be respectively 27% and 3% for HIV-infected and non-HIV-infected women. 13 Elsewhere in Africa, there have been reports that as much as half of HIV-1-infected women in the general population have CIN.…”

“…1 In the capital, Nairobi, HIV-infected women in the general population have been found to have a notably higher prevalence of cervical HPV infection than non-HIV-infected women (49% vs. 17%), together with a higher prevalence of LSIL (21% vs. 6.9%) and HSIL and cancer (5.8% vs. 0.6%). 9 Sex workers are a population subgroup at high risk for HIV and HPV infections 10 due to their participation in high-risk sexual practices (e.g., unprotected vaginal and/or anal sex), sex with multiple partners, and higher levels of symptomatic or untreated sexually transmitted infections (STIs). Longitudinal data from the East African region on cervical neoplasia among sex workers are scarce.…”

Pap smear analysis of HIV Positive Rural Females of West Godavari District of Andhra Pradesh India

“…9 In the present study HIV positive females withlower CD4 counts (around 100) were prone for SIL and thus appeared more likely to have severe lesions indicating low CD4 count, high HIV viral load and or infection with high-risk HPV types are associated with the presence of SIL. Yamada R et al 10 in Nairobi, Kenya, Leroy V at al 11 in Kigali, Rwanda and Parham GP et al 8 in Lusaka, Zambia also observed greater association of SIL with Human Papilloma Virus and low CD4 count.…”