In sub-Saharan Africa, invasive cervical cancer (ICC) incidence and mortality are among the highest in the world. This crosssectional epidemiological study assessed human papillomavirus (HPV) prevalence and type distribution in women with ICC in Ghana, Nigeria, and South Africa. Cervical biopsy specimens were obtained from women aged 21 years with lesions clinically suggestive of ICC. Histopathological diagnosis of ICC was determined by light microscopy examination of hematoxylin and eosin stained sections of paraffin-embedded cervical specimens; samples with a confirmed histopathological diagnosis underwent HPV DNA testing by polymerase chain reaction. HPV-positive specimens were typed by reverse hybridization line probe assay. Between October 2007 and March 2010, cervical specimens from 659 women were collected (167 in Ghana, 192 in Nigeria and 300 in South Africa); 570 cases were histologically confirmed as ICC. The tumor type was identified in 551=570 women with ICC; squamous cell carcinoma was observed in 476=570 (83.5%) cases. The HPV-positivity rate in ICC cases was Key words: human papillomavirus, invasive cervical cancer, sub-Saharan Africa Abbreviations: ADC: adenocarcinoma; CI: confidence interval; DEIA: DNA enzyme immune assay; FIGO: federation of gynecology and obstetrics; HPV: human papillomavirus; ICC: invasive cervical cancer; LiPA 25 : line probe assay using 25 type-specific hybridization probes; SCC: squamous cell carcinoma; PCR: polymerase chain reaction Conflicts of interest: LD declares to have received institutional grants from GlaxoSmithKline group of companies and also declares to have received institutional grants from another pharmaceutical company (there is also one pending grant). Further, LD declares to have received payment for lectures and also receives royalties for a book chapter. IA declares to have received payment from GlaxoSmithKline group of companies for travel, food and accommodation and also declares to have served as a member of IDMC for other clinical studies. IA also has received payment for participating at a workshop. RA declares to have received payment from GlaxoSmithKline group of companies towards administrative and laboratory fees and also declares to have received payment for public lectures on cervical cancer. GD declares that her institution (University of Pretoria) received payments (direct and indirect costs) for including patients into the current trial as well as payments for travel for the purpose of meetings. TS declares to have received institutional grants, travel support and honorarium for lectures and articles written for the GlaxoSmithKline group of companies and other pharmaceutical companies; TS is also part of the HPV advisory board. LS declares to have received institutional grant. EW declares to have received payment from GlaxoSmithKline group of companies towards administrative and laboratory fees and travel support for this study. He also declares to have received payments for a cervical cancer advocacy project and for conducting a training ...

ClinicalTrials.gov identifier: NCT00610168 .

This article presents the data on the HPV prevalence, HPV type distribution, and their role in cervical carcinogenesis in 5 Asian countries. These data are of relevance to public health authorities for evaluating the existing and future cervical cancer prevention strategies including HPV-DNA testing-based screening and HPV vaccination in these Asian populations.

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BackgroundFew studies have assessed long term persisting immunity against hepatitis B virus (HBV) in children vaccinated during infancy with combined vaccines containing recombinant HBV surface antigen (HBs). We assessed antibody persistence and immune memory in children 4-5 years of age, previously vaccinated with four doses of combined hexavalent DTPa-HBV-IPV/Hib vaccine (Infanrix hexa™).MethodsImmune memory was assessed in 301 children through administration of a challenge dose of monovalent HBV vaccine.ResultsAt 4-5 years of age, 85.3% of subjects had persisting anti-HBs antibody concentrations ≥ 10 mIU/mL, rising to 98.6% after the HBV challenge dose. All but 12 subjects (95.8%) achieved post-challenge anti-HBs concentrations ≥ 100 mIU/mL. The post-challenge anti-HBs GMC rose by 100-fold compared to pre-challenge concentrations. An anamnestic response to the HBV vaccine challenge was observed in 96.8% of subjects, including 17/21 (81.0%) of children with initially undetectable antibodies (<3.3 mIU/mL). All but 4 of 42 subjects (90.5%) with anti-HBs antibodies <10 mIU/mL prior to the challenge dose, achieved seroprotective levels afterwards. A 4-fold rise in antibody concentration after the challenge dose was observed in 259/264 (98.1%) of initially seropositive subjects. The magnitude of the post-challenge responses was proportional to pre-challenge anti-HBs levels. No serious adverse events were reported during the study.ConclusionThe combined DTPa-HBV-IPV/Hib vaccine induced lasting immune memory against hepatitis B. Long term protection afforded by DTPa-HBV-IPV/Hib is likely to be similar to that observed following priming with monovalent HBV vaccines.Trial registrationhttp://www.clinicaltrials.gov 106789 NCT00411697