Prevalence, incidence, and distribution of human papillomavirus types in female sex workers in Kenya

Abstract

Female sex workers (FSWs) have a notably high risk of acquiring human papillomavirus (HPV) infections. Relatively few studies address the type-specific prevalence and incidence of HPV among FSWs in sub-Saharan Africa. FSWs (n = 348) attending the Korogocho clinic in Nairobi, Kenya participated from August 2009 to March 2011. HPV DNA was detected using the SPF10-LiPA25 PCR assay. Baseline prevalence of HPV infection and cervical dysplasia were calculated, stratified by HIV-serostatus. Incidence rate (IR) of infection was calculated as number of new infections from baseline over person-months among 160 HPV-negative participants with complete 12-month follow-up. Baseline HPV prevalence was 23.6% for any HPV and 20.4% for high-risk HPV (hrHPV) types. Most prevalent types were HPV52 (10.1%), HPV35 (2.3%), and HPV51 (2.3%). A quarter (24%) of participants were HIV-positive. HPV prevalence was higher in HIV-positive (32.1%) than HIV-negative (20.8%) participants. hrHPV prevalence was higher in HIV-positive (27.4%) than HIV-negative (18.2%) women. During follow-up, HPV IR was 31.4 (95% CI: 23.8–41.5) for any HPV and 24.2 (95% CI: 17.9–32.8) for hrHPV types. HPV52 had the highest IR (6.0; 95% CI: 6.5–10.3). Overall HPV and hrHPV prevalence were lower than expected, but both prevalence and incidence were higher in HIV-positive than in HIV-negative women.

Distribution of Human Papillomavirus (HPV) Genotypes in HIV-Negative and HIV-Positive Women with Cervical Intraepithelial Lesions in the Eastern Cape Province, South Africa

“…This observation was similar to other studies from South Africa and Kenya, where HPV16 and 35 were the most common genotypes in HIV-positive or HIV-negative women with high-grade squamous intraepithelial lesions or CIN2/3 [28,31]. However, a study among sex workers from Kenya showed that HPV52 was the most prevalent HPV type and more likely to be present as a single infection in women with severe lesions (HSIL/SCC) [32]. Furthermore, a recent cross-sectional study by Dovey (2018) among women from four developed countries (Iceland, Norway, Sweden, and Denmark) reported a different distribution of HPV types, with HPV16, 31, and 52 present in CIN2 cases and HPV 16, 31, and 33 detected in CIN3 cases [33].…”

Type-specific incidence, persistence and factors associated with human papillomavirus infection among female sex workers in Benin and Mali, West Africa

“…Moreover, comparisons between studies are difficult because of the various methods used to calculate HPV incidence and the differences in the assays used to detect HPV. Whereas we observed a HR-HPV incidence rate of 46.98 per 1000 women-months, the corresponding figure among FSWs in Spain was 13.5 per 100 women-years (Gonzalez et al 2011), while another study carried out in Kenya reported a 12-month cumulative incidence of 24.2% (Sweet et al 2020). Nevertheless, whatever the methods of calculation, HPV incidence rates in FSWs have systematically been shown to be higher than among women from the general population.…”

“…These differences are mainly due J o u r n a l P r e -p r o o f to the variation in the epidemiological distribution pattern of HPV types observed across the SSA regions (de Sanjose et al 2007). In addition, other factors such as the HPV genotyping methods and the number of HPV types detected by such methods (25 HPV types in Kenya study (Sweet et al 2020) and 37 HPV in our study) may be explain these variations as well as the differences in HPV incidence rates across studies.…”

“…The highest type-specific incidence rates of HR-HPV in our study were observed with HPV59, HPV16 and HPV35. This pattern was HPV52, HPV31 and HPV51 in a study conducted among FSWs in Kenya (Sweet et al 2020). These differences are mainly due J o u r n a l P r e -p r o o f to the variation in the epidemiological distribution pattern of HPV types observed across the SSA regions (de Sanjose et al 2007).…”

“…In both Benin and Mali, these incidence rates are also lower in women from the general population (ASIR of 15.1 per 100,000 and 36.4 per 100,000 women, respectively) as compared with those observed in FSWs. These relatively higher incidence rates of HPV infections observed in FSWs are related to a combination of several risk factors, including repeated exposures to unprotected sex, high number of sexual partners as well as elevated prevalence of HIV and other STIs (Sweet et al 2020).…”