Patterns of prevalent HPV and STI co-infections and associated factors among HIV-negative young Western Cape, South African women: the EVRI trial

Menezes, Lynette; Pokharel, Ubin; Sudenga, Staci L.; Botha, Matthys H.; Zeier, M; Abrahamsen, Martha; Glashoff, Richard H.; Engelbrecht, Susan; Loeff, Maarten F. Schim van der; Laan, Louvina E van der; Kipping, Siegfried; Taylor, Douglas; Giuliano, Anna R.

doi:10.1136/sextrans-2016-053046

Cited by 33 publications

(39 citation statements)

References 35 publications

(43 reference statements)

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“…A high burden of concurrent STIs was observed in this study, similar to a recently reported study among Western Cape young women [ 34 ]. In addition to HPV, other STIs increase the risk of HIV acquisition and transmission [ 35 ].…”

Section: Discussionsupporting

confidence: 90%

High human papillomavirus (HPV) prevalence in South African adolescents and young women encourages expanded HPV vaccination campaigns

Mbulawa

Schalkwyk

et al. 2018

PLoS ONE

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The objectives of the study were to investigate prevalence of cervical human papillomavirus (HPV) genotypes to inform HPV vaccination strategy in South Africa and to study factors associated with HPV prevalence. Sexually active, HIV-negative women, aged 16–22 years recruited from Soweto (n = 143) and Cape Town (n = 148) were tested for cervical HPV and other genital infections. Overall HPV prevalence was 66.7% (194/291) in young women. Cape Town women were more likely to have multiple HPV infections than the Soweto women (48.0%, 71/148 versus 35.0%, 50/143 respectively, p = 0.033) and probable HR-HPV types (34.5%, 51/148 versus 21.7%, 31/143 respectively, p = 0.022). The most frequently detected HPV types were HPV-16 (11.7%), HPV-58 (10.3%), HPV-51 (8.9%), HPV-66 (8.6%), HPV-18 and HPV-81 (7.6% each). HPV types targeted by the bivalent HPV vaccine (HPV-16/18) were detected in 18.6% (54/291) of women, while those in the quadrivalent vaccine (HPV-6/11/16/18) were detected in 24.7% (72/291) of women; and those in the nonavalent vaccine (HPV-6/11/16/18/31/33/45/52/58) were detected in 38.5% (112/291) of women. In a multivariable analysis, bacterial vaginosis remained significantly associated with HPV infection (OR: 4.0, 95% CI: 1.4–12.6). Women were more likely to be HPV positive if they had received treatment for STI during the past 6-months (OR: 3.4, 95% CI: 1.1–12.4) or if they had ever been pregnant (OR: 2.3, 95% CI: 1.1–5.5). Compared to women who reported only one sexual partner, those with increased number of lifetime sex partners were more likely to have HPV (4–10 partners: OR: 2.9, 95% CI: 1.1–8.0). The high prevalence of HPV types targeted by the nonavalent HPV vaccine encourages the introduction of this vaccine and catch-up HPV vaccination campaigns in South Africa. The high burden of BV and concurrent STIs also highlights the need to improve the prevention and appropriate management of sexually-acquired and other genital tract infections in South African youth.

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Section: Discussionsupporting

confidence: 90%

High human papillomavirus (HPV) prevalence in South African adolescents and young women encourages expanded HPV vaccination campaigns

Mbulawa

Schalkwyk

et al. 2018

PLoS ONE

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“…Alcohol ( 70 ) and tobacco use ( 71 - 73 ) also have a correlation with increased HPV infection independent of the number of sexual partners, so avoidance of these substances is advisable. A study of South African women showed high rates of co-infection with sexually-transmitted infections and HPV, most commonly herpes simplex type 2 and chlamydia trachomatis ( 74 ). Likewise, higher number of sexual partners has been repeatedly demonstrated as a risk factor for genital HPV infection ( 29 , 66 , 75 - 77 ).…”

Section: Current Therapies Against Hpvmentioning

confidence: 99%

Relationship between human papillomavirus and penile cancer—implications for prevention and treatment

Kidd

Chaing

Chipollini

et al. 2017

Transl. Androl. Urol.

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Penile cancer is a rare disease in the United States, but rates are increasing, causing concern. Several risk factors have been associated with the disease, including human papillomavirus (HPV) infection. Knowledge of HPV pathogenesis has led to the development of a vaccine, which has proven instrumental in reducing the incidence of female HPV-related cancers, but results in men have yet to be elucidated. Fortunately, rates of vaccination are up-trending in both males and females in the past several years. In addition, targeted therapies are the focus of several ongoing research efforts. Some of these therapeutics are currently in use, while several are in trials. With continued patient education and research, both treatment and prevention of HPV-related pre-malignant lesions and penile cancer will likely diminish.

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“…A staggering 44% of women were infected with Chlamydia, 16% of whom had at least one additional STI. The Chlamydia infection rate among these women is substantially higher than reported among young sexually active women from other parts of SA, including rural KwaZulu-Natal (25%) (Kleppa et al 2015) and a different area in Cape Town (15%) (Menezes et al 2017). STI management remains problematic in developing countries where laboratory-based testing is frequently unavailable and where quality of STI care may be lacking (availability of medications, adherence to STI guidelines, condom provision and partner notification counselling [Kohler et al 2017]).…”

Section: Discussionmentioning

confidence: 98%

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

Lennard

Dabee

Barnabas

et al. 2017

Suid-Afrikaanse Tydskr Natuurwetenskap Tegnol

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Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16-22-year-old, HIV-negative South African women from a low-income, highpopulation-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7), 7% as BV-intermediate (Nugent score 3-6) and 38% as BV-negative (Nugent 0-2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratorybased testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV. Hoë voorkomskoers van bakteriële vaginose en Chlamydia in 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Jong Suid-Afrikaanse vroue uit hulpbron-arm gemeenskappe staar verskeie uitdagings in die gesig in terme van hul seksuele en reproduktiewe gesondheid. Hier beskryf ons die voorkoms van vaginale mikrobiota en seksueel oordraagbare infeksies (SOI's) onder 102; 16-22-jarige MIV-negatiewe Suid-Afrikaanse vroue uit 'n lae-inkomste, hoë-bevolkingsdigtheid gemeenskap in Kaapstad. Vaginale mikrobiota is met behulp van 16S rRNA amplikon volgorde-bepaling geprofileer; bakteriese vaginose (BV) status is met behulp van 'n Nugent-telling vasgestel; en SOI's is deur middel van 'n multipleks polimerase kettingreaksie bepaal. SOI's was algemeen, met 55% van die vroue wat ten minste een SOI gehad het; 41% wat met hoë-risiko menslike papillomavirus (MPV) besmet was, en 'n verdere 28% wat met laerisiko-MPV besmet was; 44% van die vroue was met Chlamydia besmet, waarvan 16% een of meer addisionele SOI gehad het. BV persentasies was ook baie hoog, met 55% van die vroue wat as BV-positief (Nugent-telling ≥7) geklassifiseer is, 7% as BV-intermediêr (Nugent-telling 3-6), en 38% as BVnegatief (Nugent-telling 0-2). Streptococcus (Streptococcus agalactiae), die grootste oorsaak van neonatale sepsis, was teenwoordig in 25% van die BV-positiewe vroue en 28% van die BV-negatiewe vroue, en was dus meer onder BV-negatiewe vroue. Beide Chlamydia-infeksie en BV kan re...

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Patterns of prevalent HPV and STI co-infections and associated factors among HIV-negative young Western Cape, South African women: the EVRI trial

Abstract: NCT01489527; Post-results.

Cited by 33 publications

References 35 publications

High human papillomavirus (HPV) prevalence in South African adolescents and young women encourages expanded HPV vaccination campaigns

High human papillomavirus (HPV) prevalence in South African adolescents and young women encourages expanded HPV vaccination campaigns

Relationship between human papillomavirus and penile cancer—implications for prevention and treatment

High rates of bacterial vaginosis and Chlamydia in a low-income, high-population-density community in Cape Town

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