Correlates of HPV: a cross-sectional study in women with normal cytology in north-central Morocco

Abstract

Introduction: Epidemiological studies have shown the association between risk of developing cervical cancer and the persistence of high-risk papillomavirus types in addition to some co-factors. However, little is known about co-factors associated with human papillomavirus (HPV) infection, especially in developing countries. This study aims to determine HPV status and associated risk factors in women with normal cytology living in the north-central area of Morocco. Methodology: From February 2007 to December 2008, a total of 925 women consulting in the gynaecological department of Fez University Hospital were asked about sociodemographic characteristics and reproductive and sexual health. Cervical samples were collected for cytological examination and HPV DNA detection. Data collected from 751 women with normal cytology were used in this study to assess the correlation between HPV infection and potential risk factors. Results: High prevalence of HPV infection was detected (42.5%). The highest infection rate was observed in women aged >45 years and in those with history of abortion (OR:3.76; 95%CI[1.77-7.98]) fibroma, polyp or cysts (OR:1.68; 95%CI[1.07-2.65]). No significant association was detected with other reproductive health and risk factors including oral contraception. Conclusion: In spite of the insignificant association of HPV infection with age, health authorities should seriously consider and implement strategies to increase and maintain a cervical cancer screening programme in women aged 45 and above. More attention must be given to women with gynaecological history (abortion, fibroma, polyp or cysts) since these events may be predictors of HPV infection. Investigations on partner sexual behaviour and some specific hygienic habits, especially public Turkish bath use, are needed to clarify the HPV incidence in this region.

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

“…In this study, we found a significantly higher 481 prevalence of HPV infection in women living with HIV/AIDS (74.50%) and HR-HPV types were present in the vast majority of cases (75%). These findings highlighted that the HPV prevalence in the HIVpositive Moroccan women was significantly higher than observed in the general population (15.7%-43.1%) [6][7][8]. This seems to be in line with other previous reports which documents high proportion of HIVinfected women carrying varieties of HR-HPV types [27,28].…”

“…This result seems to be in line with previous reports [36,44]. In contrast, this molecular epidemiology profile was not consistent with observed in HIV-negative women [6][7][8] or women with CC in Morocco [9][10][11][12], in whom HPV 16 and 18 predominate. Such discrepancies between groups (HIVpositive and HIV-negative) has been reported in previous studies and may partly due to immune system deficiency [30,45].…”

“…This heterogenous virus family includes more than 200 genotypes [5]. Previous studies in Moroccan women have been reported an inconsistent prevalence of HPV with 15.7% [6] in Rabat and 42.5-43.1% in Fez region [7,8]. However, the prevalence was much higher, ranging from 62% to 92%, among Moroccan women with CC [9][10][11][12].…”

Human papillomaviruses in cervical specimens of women residing in Riyadh, Saudi Arabia: a hospital-based study

“…We are in the process of starting a prospective study to measure E6/E7 mRNA [28] in fresh cervical specimens and then follow those positive cases to explore the progress to cervical carcinoma. We also would suggest that screening and triage of older women should be implemented soon, as planned in Morocco [29] and as performed in the developed world [30].…”

Visual Inspection of Acetic Acid (VIA) as a Promising Standard for Cervical Cancer Screening

“…The range of HPV infection in cytologically normal women was reported to range between 1.4% in Spain to 25.6% in Nigeria. 9 Molano et al 10 reported the prevalence of HPV in 1,859 subjects with normal cytology was 14.8%, while Bennani et al 11 reported a very high rate, which was 42.5%. HPV prevalence in cytologically normal women in Honduras as reported by Tabora et al was even as high as 51%.…”