Human Papillomavirus Infection and Cervical Cytology in HIV‐Infected and HIV‐Uninfected Rwandan Women

Abstract

Background Data on human papillomavirus (HPV) prevalence are essential for developing cost-effective cervical cancer prevention programs. Methods In 2005, 710 human immunodeficiency virus (HIV)–positive and 226 HIV-negative Rwandan women enrolled in an observational prospective cohort study. Sociodemographic data, CD4+ cell counts, and cervical specimens were obtained. Cervicovaginal lavage specimens were collected from each woman and tested for >40 HPV types by a polymerase chain reaction assay; HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were considered primary carcinogenic HPV types. Results The prevalence of HPV was higher in HIV-positive women than in HIV-negative women in all age groups. Among HIV-infected women, 69% were positive for ≥1 HPV type, 46% for a carcinogenic HPV type, and 10% for HPV-16. HPV prevalence peaked at 75% in the HIV-positive women aged 25–34 years and then declined with age to 37.5% in those ≥55 years old (Ptrend < .001). A significant trend of higher prevalence of HPV and carcinogenic HPV with lower CD4+ cell counts and increasing cytologic severity was seen among HIV-positive women. Conclusions We found a higher prevalence of HPV infection in HIV-positive than in HIV-negative Rwandan women, and the prevalence of HPV and carcinogenic HPV infection decreased with age.

Human Papillomavirus Genotypes in Invasive Cervical Carcinoma in HIV Seropositive and Seronegative Women in Zimbabwe

“…Unlike in previous reports [18,19], we found no significant difference in the prevalence of multiple genotypes by HIV status. While this could be attributed to our small sample size, recent studies have also shown that advances in technology and improved DNA extraction protocols have resulted in increased detection of HPV genotypes [20], and therefore the unmasking of the role played by previously underestimated genotypes.…”

Evaluation of the genetic variability of human papillomavirus type 52

“…cation of branch E, it may represent the most widely spread variant. The same E6 and L1 sequences were also found in Europe (Germany) (21), Africa (Rwanda) and North America (Costa Rica) (11,22,23). We speculate that this variant may be derived from the worldwide migration of the European host.…”

Human Papillomavirus Infections: Epidemiology, Clinical Aspects and Vaccines

“…The prevalence of HPV was significantly higher in the HIV positive group and adjusted for age (25-34 years 75% vs 29%; 35-44 years 64 vs 7%; 45-54 years 57% vs 13% and over 55 years 38% vs 0%) [47]. In addition 46% of HIV positive women had high-risk types of HPV and 35% were infected with multiple types and in turn, this was associated with higher risk of abnormal cytological findings.…”

“…There is good evidence provided by randomised placebocontrolled trials that these vaccines prevent both persistent infection with the types included in the vaccines, as well as pre-invasive lesions of the anogenital tract associated with the types present in the vaccines [47][48][49][50][51][52][53].…”