Unique Human Papillomavirus–Type Distribution in South African Women With Invasive Cervical Cancer and the Effect of Human Immunodeficiency Virus Infection

Aardt, M.C. Van; Dreyer, Greta; Pienaar, Hannelie Francina; Karlsen, Frank; Hovland, Siri; Richter, Karin Louise; Becker, Piet J.

doi:10.1097/igc.0000000000000422

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…The current study demonstrated the high HPV/HIV co-infection of 24.4%, with high hr-HPV prevalence across almost all age groups and more multiple hr-HPV infection in HIV-positive women than compared to HIV-negative women. These findings are consistent with previous studies reporting higher prevalence of HPV [9, 27, 30, 35] and higher frequency of infection with multiple HPV types among HIV infected women [30, 32, 36]. A number of risk factors for HPV infection among women have been demonstrated in previous studies, including having more than one partner, early sexual initiation, age and marital status.…”

Section: Discussionsupporting

confidence: 92%

“…According to Winer and colleagues, the actual first peak of HPV infection might be before the age of 25 years, as women are usually infected after sexual initiation [29]. HPV16 and 18 types have been found to be the most prevalent high risk types in most studies [4, 26–28, 30–32], yet in the current study we were not able to establish that. However, we observed high frequency of hr-HPV31/33/35/52/58 group types among the study population.…”

Section: Discussioncontrasting

confidence: 66%

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Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

et al. 2017

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BackgroundHigh risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland.MethodsA total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays.ResultsThe overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3–29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6–7.1, OR = 4.6, 95%CI: 2.8–7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3–13.4, p<0.021 respectively).ConclusionThe prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV infected people.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 66%

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

et al. 2017

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“…Our findings that the prevalence and persistence of single, multiple, lrHPV and hrHPV infections was higher among HIV-positive compared to HIV-negative women are similar to other reports from SSA (31, 32) The increased prevalence and persistence of HPV infection in immunosuppressed individuals suggests that cell-mediated immune response may play an important role in the resolution and control of HPV infection (33). Although some studies have suggested that the association between HIV infection and increased prevalence of HPV infection and disease is related to the immunosuppression seen in HIV infection, there is also some evidence that mechanisms other than immunosuppression, such as direct molecular interactions between HIV and HPV viral genes, may influence the natural history of HPV (34–37).…”

Section: Discussionsupporting

confidence: 90%

Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women

Adebamowo

Olawande

Famooto

et al. 2017

Front. Public Health

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BackgroundThe prevalence, persistence, and multiplicity of human papillomavirus (HPV) infection appears different comparing HIV-positive to HIV-negative women. In this study, we examined prevalent, persistent, and multiple low- and high-risk cervical HPV infections in HIV-negative and HIV-positive women.MethodsWe studied 1,020 women involved in a study of HPV infection using SPF25/LiPA10. Two study visits were scheduled, at enrollment and 6 months afterward. At each study visit, research nurses used a cervical brush to collect samples of exfoliated cervical cells from the cervical os, from all the study participants. Exact logistic regression models were used to estimate associations between HIV and HPV infections.ResultsThe mean (SD) age of the study participants was 38 (8) years, 56% were HIV-negative and 44% were HIV-positive. Among HIV-negative women at baseline, single low-risk HPV (lrHPV) infections occurred in 12%; multiple lrHPV in 2%; single high-risk human papillomavirus (hrHPV) infections in 9%, and multiple hrHPV infections in 2%. Single lrHPV infections were persistent in 6%, but there was no persistent multiple lrHPV infections. Single hrHPV infections were persistent in 4% while multiple hrHPV infections were persistent in 0.3%. Among HIV-positive women at baseline, single lrHPV infections occurred in 19%, multiple lrHPV in 6%, single hrHPV infections in 17%, and multiple hrHPV infections occurred in 12%. Single lrHPV infections were persistent in 9%, multiple lrHPV infections in 0.6%, single hrHPV infections in 13%, while multiple hrHPV were persistent in 3%. Prevalent, persistent, and multiple infections were more common in HIV-positive women, compared to HIV-negative women. In multivariate models adjusted for age, marital status, socioeconomic status, age at sexual initiation, and douching, the odds ratios comparing HIV-positive to HIV-negative women, were 2.09 (95% CI 1.47–2.97, p < 0.001) for prevalent lrHPV, 1.26 (95% CI 0.66–2.40, p 0.47) for persistent lrHPV infections, 3.38 (95% CI 2.34–4.87, p < 0.001) for prevalent hrHPV, and 4.49 (95% CI 2.26–8.91, p < 0.001) for persistent hrHPV infections.ConclusionHIV infection was associated with higher prevalence of lrHPV, hrHPV, and persistence hrHPV infections, but not persistent lrHPV infections.

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“…A study in neighbouring Burkina Faso found HPV35 to be the second most prevalent among sex workers with high prevalence of HIV [ 37 ]. Another study conducted in South Africa reported HPV35 as the third most prevalent genotype identified among 154 HIV-seronegative women with ICC [ 45 ]. Pirek et al [ 46 ] found HPV35 the fifth commonest among Cameroonian women with ICC and HPV45 was the second most prevalent type.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of cervical human papillomavirus (HPV) infection and squamous intraepithelial lesions (SIL) among a cohort of HIV-infected and uninfected Ghanaian women

et al. 2017

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BackgroundThere is limited data in Ghana on the epidemiology of HPV and cervical neoplasia and their associations with HIV. This study aimed to compare among HIV-1 seropositive and HIV-seronegative Ghanaian women: (1) the prevalence, genotype distribution and risk factors associated with cervical HPV infection; and (2) the prevalence and risk factors associated with abnormal cervical cytology.MethodsA comparative frequency-matched study was conducted in a systematic sample of women aged ≥18 years attending HIV and general outpatient clinics in Cape Coast Teaching Hospital, Ghana. Participants were interviewed and cervical samples collected for HPV genotyping (Seegene Anyplex-II HPV28) and cytological testing.ResultsOverall, 333 women were recruited, 163 HIV-1 seropositive and 170 HIV-seronegative women of mean age 43.8 years (SD ±9.4)) and 44.3 years (SD ±12.8), respectively. The prevalence of 14 high-risk (hr) HPV genotypes was higher among HIV-1 seropositive women (65.6% vs. 30.2%, P < 0.0001), as was proportion with multiple hr.-HPV infections (60.6% vs. 21.3%, P < 0.0001). HPV35 was the most prevalent hr.-HPV genotype in both groups (11.9% and 5.3%). The main factors associated with hr.-HPV infection were age for HIV-positive women and circumcision status of main sexual partner for both HIV-negative and positive women.Abnormal cervical cytology prevalence was higher among HIV-1 seropositive women (any SIL: 14.1% vs. 1.2%, P < 0.0001; low-grade SIL [LSIL]: 4.9% vs. 0.6%, P = 0.02; high-grade SIL: 1.8% vs. 0%, P = 0.07). Among HIV-1 seropositive women, number of pregnancies and CD4+ cell count were associated with LSIL+ cytology. There was strong association between LSIL+ abnormalities and HPV35 (aOR = 4.7, 95%CI: 1.3–17.7, P = 0.02).ConclusionsHIV-1 infected women bear significant burden of HPV infection and related disease. Prevention and screening programmes should be specifically deployed for this population in Ghana.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3682-x) contains supplementary material, which is available to authorized users.

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Unique Human Papillomavirus–Type Distribution in South African Women With Invasive Cervical Cancer and the Effect of Human Immunodeficiency Virus Infection

Cited by 21 publications

References 20 publications

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women

Epidemiology of cervical human papillomavirus (HPV) infection and squamous intraepithelial lesions (SIL) among a cohort of HIV-infected and uninfected Ghanaian women

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