Prevalence of viral sexually transmitted infections and HPV high-risk genotypes in women in rural communities in the Department of La Paz, Bolivia

Abstract

Background: Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia. Methods: Three hundred ninety-four female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ 2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests. Results: The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections. Conclusions: Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017.

Cervical cancer prevention: Feasibility of self-sampling and HPV testing in rural and urban areas of Bolivia: An observational study

“…In 2014, Tera ´n Caldero ´n [19] enrolled 868 women reporting a prevalence of 18.1% with HPV 16 as the most prevalent type (3.7%), followed by 31, 52 and 51. In 2020, Patzi-Churqui and co-workers [20] enrolled 364 women and reported a prevalence by genotype very similar to those of our study, even taking into account the different method used for testing: the most prevalent high-risk HPV types were HPV 56, 39 and 31, followed by HPV 16 and 18. The genotyping results of our survey are consistent with data reported in these studies.…”

“…Cervical cancer represents the main cause of death of women in Bolivia [3]. However, compared to other Latin American countries, data on HPV prevalence are scarce and fragmented and often not representative of the great socio-environmental variability of the Bolivian territory [18][19][20]. Therefore, the Bolivian Ministry of Health promoted a national vaccination…”

The Prevalence, Genotype Distribution and Risk Factors of Human Papillomavirus in Tunisia: A National-Based Study

“…This latter region could be considered as mostly rural, and it is known that rural communities are typically more conservative than urban communities. Different studies from diverse geographical areas/countries reported that HPV infection prevalence was higher in urban than rural areas [ 18 , 19 , 20 , 21 ].…”

HIV-1 Exploitation of Dendritic Cell Functionality and Initial Responses in Mucosal Tissues : Elucidation of Influence of HIV-1 Complement Opsonization, and HIV-1-HSV-2 Co-infection

“…In regions where HIV prevalence is high, there are also high prevalence rates of tuberculosis 179 , human papilloma virus (HPV) 180,181 , and herpes simplex virus 2 (HSV-2) 182 . The presence of inflammatory conditions in the genital tract, such as during a pre-existing HSV-2 183 or HPV infection, increases the risk of HIV-1 acquisition 181 .…”