HPV types, cervical high-grade lesions and risk factors for oncogenic human papillomavirus infection among 3416 Tanzanian women

Kjær, Susanne K.; Manongi, Rachel; Swai, Patricia; Waldstroem, Marianne; Iftner, Thomas; Wu, Chunsen; Mwaiselage, Julius; Rasch, Vibeke

doi:10.1136/sextrans-2019-054263

Cited by 14 publications

(13 citation statements)

References 36 publications

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“…We found a high overall burden (32.5%) of high-risk HPV infections in our study population, similar to results from another study in our Western Kenya region [34]. A number of other studies done in SSA report lower [33,[35][36][37][38][39] or similarly high [40,41] HPV burden. All these studies were facility-based with often unknown cervical morbidity and different distribution of risk factors for HPV acquisition, i.e.…”

Section: Hpv Burdensupporting

confidence: 90%

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

Orang’o

Were

Rode

et al. 2020

Infect Agents Cancer

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Background Screening of unvaccinated women remains essential to mitigate the high morbidity/mortality of cervical cancer. Here, we compared visual inspection with acetic acid (VIA), recommended by WHO as the most cost-effective screening approach in LMICs, with HPV-based screening, and usage of p16INK4a/Ki-67 dual stain cytology. Methods We prospectively enrolled women participating in a VIA-based cervical cancer screening program in two peri-urban health centers of Kenya. Consenting women had a VIA examination preceded by collection of a liquid-based cytology sample from the cervix stored in PreservCyt medium (Hologic®). Analysis of all samples included a hrHPV DNA test and evaluation of a p16INK4a /Ki-67 (CINtecPLUS®) dual stained slide that was prepared using the ThinPrep® 2000 Processor and evaluated by a pathologist trained in the methodology. Results In 701 of a total of 800 women aged 18–64 years, all three investigations were performed and data could be analyzed. The HPV, VIA and dual stain cytology positivity were 33%, 7%, and 2% respectively. The HPV positivity rate of VIA positive cases was 32%. The five most common HPV types were HPV16, 52, 68, 58 and 35. The OR among HIV infected women of an HPV infection, VIA positivity and positive dual stain cytology were 2.6 (95%CI 1.5–4.3), 1.9 (95%CI 0.89–4.4) and 3.4 (95%CI 1.07–10.9) respectively. The sensitivity of VIA to detect a p16INK4a/Ki-67 positive transforming infection was 13% (95%CI 2–38). Conclusions Primary HPV testing appears feasible and should be considered as a primary screening test also in LMICs. The poor sensitivity of VIA renders it unsuitable as a triage test for HPV positive women. The utility of p16INK4a/Ki-67 dual stain cytology as a triage test for HPV positive women in LMICs should be further studied.

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Section: Hpv Burdensupporting

confidence: 90%

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

Orang’o

Were

Rode

et al. 2020

Infect Agents Cancer

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“…The oncogenic activity of HR-HPV types is imputed to the random introduction of the virus genomic DNA into the host genome ( Al-Shabanah et al, 2013, Liu et al, 2021. HR-HPVs are associated with high-grade lesions and CC invasiveness ( Mchome et al, 2021 ). HPV-16 and HPV-18 are the most important types, explaining the cause of ∼70% of CC cases ( Herraez-Hernandez et al, 2013b ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Genotype Distribution of Human Papillomavirus Infection among 12 076 Iranian Women

Bitarafan¹,

Hekmat²,

Khodaeian³

et al. 2021

International Journal of Infectious Diseases

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Introduction: Human papillomavirus (HPV) infection is one of the major health concerns of women in developing countries. This study gives an insight into the prevalence and genotype distribution of HPV infection and compares it with Pap smear results among Iranian women.Methods: In this study, 12 076 Iranian women underwent routine examination from November 2016 to November 2018 using HPV Direct Flow CHIP System for HPV DNA typing. Cytology was undertaken for 5138 samples.

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“…A full description of the HPV distributions according to HIV status and cytology results is published elsewhere. 33 …”

Section: Findings To Datementioning

confidence: 99%

“…Among women with high-grade lesions (HSIL+), 32.5% hadHPV 16,19.3% had HPV 58, 17.5% had HPV 31, 16.7% had HPV 18 and 16.7% had HPV 52. A full description of the HPV distributions according to HIV status and cytology results is published elsewhere 33.…”

mentioning

confidence: 99%

Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study: Cohort profile

Mchome,

Swai,

et al. 2020

BMJ Open

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PurposeCervical cancer is a major cause of death among women in Eastern Africa, and the distribution of human papillomavirus (HPV) according to HIV status is inadequately characterised in this region. In order to guide future cervical cancer preventive strategies that involve HPV testing, the Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study was established in 2015. The CONCEPT cohort aims to investigate the natural history of HPV and determine acquisition and persistence patterns of high-risk (HR) HPV among HIV-positive and HIV-negative women. Further, the influence of lifestyle and sexual/reproductive factors will be investigated. The main objective of this article is to describe how the CONCEPT cohort was established.ParticipantsWomen aged 25–60 years were enrolled from cervical cancer screening clinics in Dar-es-Salaam and Moshi, Tanzania. Data were collected at baseline, at 14 months (first follow-up) and at 28 months (second follow-up). Biological samples included two cervical swabs for careHPV DNA testing, cytology, Hybrid Capture 2, genotyping and blood samples for HIV. Visual inspection with acetic acid was performed, and sociodemographic, lifestyle and sexual/reproductive characteristics were collected through a standardised questionnaire.Findings to date4043 women were included in the cohort from August 2015 to May 2017. At baseline, 696 (17.1%) women were HR HPV positive, and among these, 31.6% were HIV positive; 139 women (3.4%) had high-grade squamous intraepithelial lesions. 3074 women (81%) attended the first follow-up. The majority attended after receiving a phone call reminder (35%) or from home via self-samples (41%). At first follow-up, 438 (14.4%) were HR HPV positive and 30.4% of these were HIV positive.Future plansA second follow-up is underway (17 December 2018–October 2020). We plan to integrate our data with a previous cross-sectional HPV study from Tanzania to increase the power of our findings. Researchers interested in collaborating are welcomed, either by extracting data or jointly requesting further investigation from the cohort.

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HPV types, cervical high-grade lesions and risk factors for oncogenic human papillomavirus infection among 3416 Tanzanian women

Cited by 14 publications

References 36 publications

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

Prevalence and Genotype Distribution of Human Papillomavirus Infection among 12 076 Iranian Women

Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study: Cohort profile

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