Molecular analysis of human Papillomavirus detected among women positive for cervical lesions by visual inspection with acetic acid/Lugol’s iodine (VIA/VILI) in Libreville, Gabon

Abstract

BackgroundThe human papillomavirus (HPV) is the causative agent of cervical cancer, which is the leading cancer-related cause of death for women in Sub-Saharan Africa. In 2013, the Gabonese Ministry of Health and the Sylvia Bongo Ondimba Foundation implemented cervical cancer screening programs based on the detection of cancerous lesions by visual inspection with acetic acid and/or Lugol’s iodine (VIA/VILI). This pilot study was set up to determine the HPV profile and analyze the nucleotide sequence variation of HPV16 circulating in patients with cervical abnormalities detected by VIA/VILI testing.MethodsThe cervical abnormalities observed upon VIA/VILI were confirmed by liquid-based cytology for all tested women. Nested PCR using the MY09/11 and GP5+/6+ primer sets was used to detect HPVs present in the extracted DNA. HPV genotypes were determined after sequencing of amplicons based on a high-throughput sequencing approach. For isolates of the HPV16 genotype, the E6 gene and the long control region (LCR) were directly sequenced using Sanger method.ResultsThe study included 87 women who showed a positive VIA/VILI result. Cervical abnormalities were found in 40.23 % of women and 40 % were classified as high-grade lesions. The HPV detection rate was 82.9 % among women with abnormal cytology. Among all the identified high-risk HPV genotypes, HPV16, 18 and 33 were the most frequent. Multiple HPV infections were observed in 42.31 % of HPV-infected women. Analysis of the HPV16 sequence variation in the E6 gene and in the LCR showed that 85.3 and 14.7 % belonged to the African and European lineages, respectively. Among the African branch variants, Af2 was the most frequently identified in this study.ConclusionThis study offers the first report of the HPV detection rate and molecular epidemiology among Gabonese women with a positive result in a VIA/VILI screening test. Moreover, data on the HPV16 sequence variation confirm the predominance of African variants in high-grade lesions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13027-016-0098-1) contains supplementary material, which is available to authorized users.

Detection of cervical human papillomavirus in women attending for cervical cancer screening by visual inspection in Cte d Ivoire

“…Several multiple concurrent HPV infections has been reported by numerous studies in particular to Cote d'Ivoire (Jaquet et al, 2010), Benin (Piras et al, 2011), Gabon (Moussavou et al, 2016) and Greece but with rates slightly lower than that obtained in our study. The prevalence of HPV genotypes obtained in our study have also been found by numerous authors in Cote d'Ivoire (Jaquet et al, 2010), within chronological order who obtained HPV 35, HPV 16 and HPV 18.…”

“…In addition, Horo et al (2012) have worked on a population of HIV-infected women and therefore when it is known that HIV infection is a factor in the development of cervical cancer. Elsewhere in Africa, notably in Mali west Africa, Teguete et al (2012) and Moussavou et al (2016) in a similar study in Gabon found in Central Africa have found a high prevalence of precancerous lesions by VIA but in Tanzania, Ngoma et al (2010) found a lower prevalence of precancerous lesions.…”

“…On the other hand, Piras et al (2011) have identified the rate of 33.2% prevalence of HPV with a presence of HPV 59 followed by HPV 35 and finally HPV 16, HPV 18 and HPV 58 as the most predominant in the female population in Benin (Piras et al, 2011). At least Moussavou et al (2016) isolated HPV 16 followed by HPV 18 and HPV 33 in Gabonese women. However, the most worldwide commonly detected types in Invasive Cervical Cancer were HPV 16 and HPV 18.…”

Human papillomavirus detection using the Abbott RealTime high-risk HPV tests compared with conventional nested PCR coupled to high-throughput sequencing of amplification products in cervical smear specimens from a Gabonese female population

“…Participating women were selected from a 960 patient cohort previously constituted from March 2013 to January 2014 during a cervical lesion screening program as part of a multi-center cross-sectional study carried out in two hospitals located in Libreville, Gabon [ 10 ]. A total of 87 women met both main inclusion criteria, i.e.…”

Cancer in Kenya: types and infection-attributable. Data from the adult population of two National referral hospitals (2008-2012)

“…In determining AF estimates for cervical cancer, we identified other African studies that reported the prevalence of HPV in cervical cancer to be between 76% to 91% [16][17][18] . However, an AF of 100% was used for this study since the causality of HPV in cervical cancer is generally known 4,19,20 .…”