Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV‐positive and HIV‐negative women in Rwanda

Abstract

The currently used quadrivalent vaccine may be insufficient to give satisfactory HPV coverage in Rwanda. HPV Screening may be effective to identify women at risk of developing cervical cancer, particularly if provided to high-risk patients.

Persistence rate of cervical human papillomavirus infections and abnormal cytology in Rwanda

“…While the rates of AIDS‐related cancers such as Kaposi's sarcoma have decreased since the introduction of combination antiretroviral therapy (cART), a similar trend has not been observed for cervical cancer . The HIV‐infected cohort in the present study was well monitored and the majority of women had normal CD4 counts and low HIV viral loads at baseline . This indicates that immune surveillance may still be compromised in HIV‐positive patients on cART.…”

“…The impact of the vaccination programme on cervical cancer incidence is not known, as it takes several years for cervical cancer to develop. We showed that the percentage of women undergoing cervical cancer screening was low . Monetary issues and not being educated about the importance of screening were reasons for not undergoing cervical cancer screening .…”

“…We showed that the percentage of women undergoing cervical cancer screening was low . Monetary issues and not being educated about the importance of screening were reasons for not undergoing cervical cancer screening . The number of trained cytologists in Rwanda is also low and therefore cervical cytology screening of the general population is not possible.…”

“…Participants were also tested at baseline and at 9 months for sexually transmitted infections (STIs; HIV infection, trichomoniasis, syphilis, hepatitis B and hepatitis C) and reproductive tract infections (RTIs; bacterial vaginosis and vaginal candidiasis). The details of the tests are described in our previous study . We wanted to assess whether sexual risk behaviour and genital infections indicated by the presence of STIs/RTIs at baseline predicted HPV persistence and the development of cytological changes.…”

“…It is well established that chronic infection with human papillomavirus (HPV) of the uterine cervix is the most important risk factor for the development of cervical squamous intraepithelial lesions and cervical cancer . In our previous study, we showed a high prevalence of HPV infections and cytological abnormalities among Rwandan women, particularly in women who were HIV positive . The degree of HPV chronicity in the Rwandan population is not known.…”