Detection of types of HPV among HIV‐infected and HIV‐uninfected Kenyan women undergoing cryotherapy or loop electrosurgical excision procedure

Abstract

Objective: To assess the baseline types of HPV infection among HIV-positive and HIVnegative women in western Kenya undergoing cryotherapy or loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia. Methods: A prospective observational study was conducted of baseline HPV characteristics of women undergoing visual inspection with acetic acid (VIA) and cryotherapy or LEEP. After a positive VIA in HIV-positive and HIV-negative women, data on demographics, CD4 count, and use of antiretroviral therapy and a cervical swab were collected. HPV typing was performed using the Roche Linear Array. Results: Of 175 participants, 86 (49.1%) were HIV-positive and had a higher prevalence of low-risk HPV types (odds ratio [OR] 5.28, P=0.005) compared with HIV-negative women. The most common high-risk (HR)-HPV types in HIV-positive women were HPV 16 (13.9%) and HPV 18 (11.1%). HIV-positive women requiring LEEP were more likely to have HR-HPV types (OR 6.67, P=0.012) and to be infected with multiple HR-HPV types (OR 7.79, P=0.024) compared to those undergoing cryotherapy. Conclusion: HIV-positive women requiring LEEP versus cryotherapy had a higher prevalence of any HR-HPV type and multiple HR-HPV types. There were no such differences in HPV types identified among HIV-negative women.

Genetic diversity in L1 gene of human papillomavirus variants in individuals with cervical cancer with and without human immunodeficiency virus in Botswana and Kenya

“…Though HPV is the main causative agent for cervical cancer, its prevalence and distribution vary in different geographical regions of the world. Several studies have shown HPV prevalence in Botswana and Kenya [2,16,25,[18][19][20][21][22][23][24][26][27][28]. However, the numbers of studies investigating the variants within HPV genotypes are limited.…”

“…Several studies in Africa have also explored the genomic diversity of HPV variants [12][13][14][15][16][17]. HPV genotypes − 16, -18, -45, and − 58 were observed among most cervical samples studied from Botswana and Kenya [2,16,25,[18][19][20][21][22][23][24][26][27][28].…”

The East Africa Consortium for human papillomavirus and cervical cancer in women living with HIV/AIDS

“…Women between the ages of 18 and 45 years with an abnormal VIA examination were tested for HPV and treated with cryotherapy for lesions not suspicious of cancer [ 38 ]. Colposcopy and biopsy were performed in women with suspicious lesions, and LEEP was performed if biopsy showed CIN2/3.…”

Human Immunodeficiency Virus Type 1 RNA Genital Tract Shedding After Cryotherapy for Cervical Intraepithelial Neoplasia in Western Kenya

“…Cervical cancer has the highest mortality of gynecologic cancers in Kenya [ 1 ]. The estimated prevalence of human immunodeficiency virus (HIV) in Kenya is 4.0% and majority of adult PWH in Kenya are women (63.5%) [ 2 ]. The high incidence of HIV and human papillomavirus (HPV) coinfection that could progress to cervical cancer raises the priority of this disease burden.…”