Infection with Human Papillomavirus and HIV among Young Women in Kampala, Uganda

Banura, Cecily; Franceschi, Silvia; Doorn, Leen Jan Van; Arslan, Annie; Wâbwire-Mângen, Fred; Mbidde, Edward; Quint, Wim; Weiderpass, Elisabete

doi:10.1086/526792

Cited by 53 publications

(69 citation statements)

References 31 publications

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“…High prevalence of HPV in women with a low SES has been shown in a few studies (Hildesheim et al, 1993;LazcanoPonce et al, 2001), but has not been confirmed in others (Deacon et al, 2000;Shapiro et al, 2003;Khan et al, 2005;Banura et al, 2008;Hibbitts et al, 2008).…”

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confidence: 95%

Differences in the risk of cervical cancer and human papillomavirus infection by education level

et al. 2009

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BACKGROUND: Cervical cancer risk is associated with low education even in an unscreened population, but it is not clear whether human papillomavirus (HPV) infection follows the same pattern. METHODS: Two large multicentric studies (case -control studies of cervical cancer and HPV prevalence survey) including nearly 20 000 women. GP5 þ /GP6 þ PCR was used to detect HPV. RESULTS: Education level was consistently associated with cervical cancer risk (odds ratio (OR) for 0 and 45 years vs 1-5 years ¼ 1.50, 95% confidence interval (CI): 1.25 -1.80 and 0.69, 95% CI: 0.57 -0.82, respectively, P for trend o0.0001). In contrast, no association emerged between education level and HPV infection in either of the two IARC studies. A majority of the women studied had never had a Pap smear. The association between low education level and cervical cancer was most strongly attenuated by adjustment for age at first sexual intercourse and first pregnancy. Parity and screening history (but not lifetime number of sexual partners, husband's extramarital sexual relationships, and smoking) also seemed to be important confounding factors. CONCLUSION: The excess of cervical cancer found in women with a low socio-economic status seems, therefore, not to be explained by a concomitant excess of HPV prevalence, but rather by early events in a woman's sexually active life that may modify the cancercausing potential of HPV infection.

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confidence: 95%

Differences in the risk of cervical cancer and human papillomavirus infection by education level

et al. 2009

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“…[2][3][4][5] In many parts of Africa, ICC is a leading cause of cancer death in women. [2][3][4][5][6][7] Though rates of ICC vary considerably in different sub-regions, cervical cancer ranks first or second (after breast cancer) in all individual sub-Saharan African countries. 8 In subSaharan Africa, over 70,000 new cases occur annually with an age standardized incidence rate of 31.0 per 100,000 women.…”

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confidence: 99%

Evaluation of safety and immunogenicity of a quadrivalent human papillomavirus vaccine in healthy females between 9 and 26 years of age in Sub-Saharan Africa

Mugo

Ansah

Marino

et al. 2015

Human Vaccines & Immunotherapeutics

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“…The overall HPV prevalence was 64% in post-partum women Previous HPV prevalence studies were conducted in women from the sexually transmitted disease clinic at the main hospitals in Kampala, Uganda, as well as at an adolescent clinic in the suburbs. The reported incidence of HPV infection in these studies ranged from 75% in women aged 12-25 years seen at an adolescent clinic 40 to 46% in women 18-55 years of age presenting in the STD clinic, 41 suggesting clearance of most HPV infections with age. The overall HPV prevalence detected in our study of women aged 18-30 years old is intermediate between these two groups, supporting this concept.…”

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confidence: 91%

Human papillomavirus prevalence and cytopathology correlation in young Ugandan women using a low‐cost liquid‐based pap preparation

Taube

Kamira

Motevalli

et al. 2010

Diagnostic Cytopathology

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Screening for HPV-driven cervical dysplasia and neoplasia is a significant public health concern in the developing world. The purpose of this study was to use a manual, low-cost liquid-based Pap preparation to determine HPV prevalence in HIV-positive and HIV-negative young women in Kampala, Uganda and to correlate cervical cytopathology with HPV-DNA genotype. About 196 post-partum women aged 18-30 years underwent rapid HIV testing and pelvic examination. Liquid-based cervical cytology samples were processed using a low-cost manual technique. A DNA collection device was used to collect specimens for HPV genotyping. HIV and HPV prevalence was 18 and 64%, respectively. Overall, 49% of women were infected with a high-risk HPV genotype. The most common high-risk HPV genotypes were 16 (8.2%), 33 (7.7%), 35 (6.6%), 45 (5.1%), and 58 (5.1%). The prevalence of HPV 18 was 3.6%. HIV-positive women had an HPV prevalence of 86% compared to 59% in HIV-negative women (P = 0.003). The prevalence of HPV 16/18 did not differ by HIV status. HIV-positive women were infected with a significantly greater number of HPV genotypes compared to HIV-negative women. By multivariate analysis, the main risk factor for HPV infection was coinfection with HIV. HIV-positive women were four times more likely to have abnormal cytology than HIV-negative women (43% vs. 11.6%, P < 0.001). These data highlight that HIV infection is a strong risk factor for HPV infection and resultant abnormal cervical cytology. Notably, the manual low-cost liquid-based Pap preparation is practical in this setting and offers an alternate method for local studies of HPV vaccine efficacy.

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Infection with Human Papillomavirus and HIV among Young Women in Kampala, Uganda

Abstract: The prevalence of HPV infection is high among young women in Kampala, Uganda. Clinics for teenagers provide an opportunity to monitor the impact of HPV vaccines and, possibly, to catch up unvaccinated young women who have recently become sexually active.

Cited by 53 publications

References 31 publications

Differences in the risk of cervical cancer and human papillomavirus infection by education level

Differences in the risk of cervical cancer and human papillomavirus infection by education level

Evaluation of safety and immunogenicity of a quadrivalent human papillomavirus vaccine in healthy females between 9 and 26 years of age in Sub-Saharan Africa

Human papillomavirus prevalence and cytopathology correlation in young Ugandan women using a low‐cost liquid‐based pap preparation

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