Human papillomavirus prevalence and risk factors among HIV-negative and HIV-positive women residing in rural Eastern Cape, South Africa

Taku, Ongeziwe; Businge, Charles Bitamazire; Mdaka, Mana Lungisa; Phohlo, Keletso; Basera, Wisdom; Garcia-Jardon, Mirta; Meiring, Tracy L.; Gyllensten, Ulf; Williamson, Anna‐Lise; Mbulawa, Zizipho Z. A.

doi:10.1016/j.ijid.2020.02.051

Cited by 47 publications

(50 citation statements)

References 53 publications

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“…The significant association of viral STIs (HSV-2 & HIV infection) with HR-HPV infection has been previously observed in other studies (Li & Wen, 2017;Taku et al, 2020). HSV-2 increases the odds of acquiring other STIs (such as NG) and is considered as the significant co-factor for HPV in the development of cervical cancer (Li & Wen, 2017;Smith et al, 2002a;Venkatesh et al, 2011).…”

Section: Discussionsupporting

confidence: 60%

“…Cohort description or description of study participants: Two hundred and five cervical samples were selected from a cross-sectional study done between September 2017 and August 2018. The cross-sectional study has been described in detail previously (Taku et al, 2020). Briefly, women aged 30 years or more attending cervical cancer screenings or for other reasons were recruited from a community-based clinic within the OR Tambo District, Eastern Cape.…”

Section: Methodsmentioning

confidence: 99%

“…HIV infection is a significant independent factor of HPV, and infection with either HPV or HIV is thought to enhance the spread of the other infection (Smith-McCune et al, 2010). HIV-positive women have been reported to have a higher prevalence and higher viral load of high-risk (HR) HPV compared to HIV-negative women (Taku et al, 2020). In addition, CT, Herpes Simplex Virus-2 (HSV-2), and NG increase the risk of HIV acquisition (Adachi et al, 2015;Johnson & Lewis, 2008;Looker et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Detection of sexually transmitted pathogens and co-infection with human papillomavirus in women residing in rural Eastern Cape, South Africa

Taku

Brink

Meiring

et al. 2021

PeerJ

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Background South African women of reproductive age have a high burden of sexually transmitted infections (STIs), including human papillomavirus (HPV) infection. However, there is limited information on the prevalence of sexually transmitted pathogens in women from rural Eastern Cape Province, South Africa. The study aims at determining the prevalence of sexually transmitted pathogens and co-infection with high-risk (HR) HPV among women from rural Eastern Cape Province, South Africa. Methods A total of 205 cervical specimens were collected from women aged ≥ 30 years from a rural community-based clinic. The samples were tested for a panel of pathogenic STIs [Chlamydia trachomatis (serovars A-K & L1-L3), Haemophilus ducreyi, Herpes Simplex Virus (Types 1 & 2), Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis (TV), and pathobionts [Mycoplasma genitalium (MG), Mycoplasma hominis (MH) and Ureaplasma spp. (UP)] using a multiplex PCR STD direct flow chip assay through a manual Hybrispot platform (Master Diagnostica, Granada, Spain). HR-HPV detection was performed by Hybrid Capture-2 assay. Results High-risk HPV prevalence was 32.2% (66/205) and HIV-1 prevalence was 38.5% (79/205). The overall prevalence of six pathogenic STIs was 22.9% (47/205), with TV having the highest prevalence (15.6%; 32/205). UP (70.2%, 144/205) and MH (36.6%, 75/205) were the most frequently detected pathobionts. Co-infection with ≥ 2 pathogens pathobionts was observed among 52.7% (108/205) participants. Of the six pathogenic STIs, three participants had more than one STI (1.46%) with the presence of MH and UP. HSV-2 (OR: 4.17, CI [1.184–14.690]) and HIV infection (OR: 2.11, CI [1.145–3.873]) were independent STIs associated with HR-HPV infection. Conclusions The high prevalence of pathogenic STIs underscores the need to improve syndromic management policy by implementing effective strategies of prevention, screening tests, and management. HSV-2 and HIV positive remain strongly associated with HR-HPV infection.

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Section: Discussionsupporting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detection of sexually transmitted pathogens and co-infection with human papillomavirus in women residing in rural Eastern Cape, South Africa

Taku

Brink

Meiring

et al. 2021

PeerJ

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“…Promising new technologies such as Table 2 Distribution of results for provider-collected (Provider) or self-collected (Self) specimen tested for HPV or visual inspection after acetic acid (VIA) by severity of the cytologic interpretation for women living with HIV. Abbreviations: N+, number of positives; %+, percent positive automated visual evaluation [27] and in vivo microscopy [28] may be better at distinguishing between clinically important and benign HPV infections, an important consideration for management of WLWH who typically have a very high prevalence of HPV [23,[29][30][31][32][33][34] that is related to the degree of HIV control [29,32,33,35]. Table 4 Sensitivity and positive predictive value (PPV), with 95% confidence interval (95%CI), of triage strategies for high-grade cervical abnormalities among women living with HIV who tested HPV positive on the provider-collected (Provider) or self-collected (Self) specimen for women living with HIV.…”

Section: Discussionmentioning

confidence: 99%

A comparison of screening tests for detection of high-grade cervical abnormalities in women living with HIV from Cameroon

Castle

Ajeh²,

Dzudie³

et al. 2020

Infect Agents Cancer

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Background: Women living with human immunodeficiency virus (WLWH), especially those living in low-and middle-income countries (LMIC), are at increased risk of cervical cancer. The optimal cervical-cancer screening strategy for WLWH has not been determined. We therefore conducted a pilot study of screening methods in WLWH living in Limbe, Cameroon. Methods: Five-hundred sixty-six WLWH, aged 25-59 years, were enrolled. After self-collecting a cervicovaginal specimen, they underwent a pelvic exam, during which a provider also collected a cervical specimen and visual inspection after acetic acid (VIA) was performed. Both self-and provider-collected specimens were tested for highrisk HPV by the Xpert HPV Test (Cepheid, Sunnyvale, CA, USA), with the residual of the latter used for liquid-based cytology. Women testing HPV positive on either specimen and/or VIA positive were referred to colposcopy and biopsies. However, because of poor attendence for follow-up colposcopy for the screen positives due to civil strife and technical issues with biopsies, high-grade cytology and/or clinical diagnosis of cancer was used as the primary high-grade cervical abnormality endpoint. Clinical performances for high-grade cervical abnormality of HPV testing and VIA for screening WLWH, and the most carcinogenic HPV genotypes and/or VIA to triage high-risk HPV-positive WLWH, were evaluated.

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“…In this study, South Africa had the highest prevalence of any HPV and multiple HPV infection while Central Africa had the least of both parameters. The difference between the African sub-regions in terms of ASIR of cervical cancer as revealed by Martel et al [5] could be due to high multiple HPV infections and HIV infection rate [23,24].…”

Section: Discussionmentioning

confidence: 99%

Racial disparities in the prevalence of vaccine and non-vaccine HPV types and multiple HPV infection between Asia and Africa: A systematic review

Okoye

Cf³

et al. 2020

Preprint

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Background: Cervical Cancer is the 6th most common and 3rd most deadly cancer among women. Despite the fact that majority of the countries in Asia and Africa have similar economy and low life expectancy, the mean age standardized incidence rate (ASIR) of cervical cancer is substantially higher in Africa than Asia. Thus, this study aimed to identify the correlates of the higher ASIR rates in Africa relative to Asia. Methods: Peer-reviewed articles published between 2004 and 2017 were selected using the PRISMA standard. Sources of articles include Google Scholar, Scopus, PubMed Central, and EMBASE. Search keywords included: HPV genotypes, cervical cancer, HPV vaccine, and multiple infection in Africa and Asia. Result: A total of 29 and 17 full-length articles were selected from Africa and Asia respectively. Based on estimates in the general population, the incidence of high-risk HPV (hrHPV) types in Africa and Asia was 3.5 and 1.0 respectively. The prevalence of HPV infection was higher in Africa than in Asia (p< 0.001). The prevalence of HPV infection between 2004-2009 and 2010-2017 decreased in Africa but increased in Asia. More so, the prevalence of multiple HPV and non-vaccine HPV infection were higher in Africa than Asia (p< 0.001). The prevalent HPV types in Africa were HPV16, HPV18, and HPV52, while that of Asia were HPV16, HPV52, and HPV58, in descending order of prevalence. This study revealed that nonavalent HPV vaccine could prevent the development of 69.3% and 83.2% of HPV associated cervical abnormalities in Africa and Asia, respectively. Conclusion: This study revealed higher prevalence of HPV infection and multiple HPV infection in Africa compared with Asia, which could be responsible for the higher ASIR in Africa. It suggests that nonavalent vaccination including cervical screening using Pap smear could prevent over 90% of the cervical abnormalities in Africa.

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Human papillomavirus prevalence and risk factors among HIV-negative and HIV-positive women residing in rural Eastern Cape, South Africa

Cited by 47 publications

References 53 publications

Detection of sexually transmitted pathogens and co-infection with human papillomavirus in women residing in rural Eastern Cape, South Africa

Detection of sexually transmitted pathogens and co-infection with human papillomavirus in women residing in rural Eastern Cape, South Africa

A comparison of screening tests for detection of high-grade cervical abnormalities in women living with HIV from Cameroon

Racial disparities in the prevalence of vaccine and non-vaccine HPV types and multiple HPV infection between Asia and Africa: A systematic review

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