TY - JOUR
T1 - High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa
AU - Chachage, Mkunde
AU - Parikh, Ajay P.
AU - Mahenge, Anifrid
AU - Bahemana, Emmanuel
AU - Mnkai, Jonathan
AU - Mbuya, Wilbert
AU - Mcharo, Ruby
AU - Maganga, Lucas
AU - Mwamwaja, Jaqueline
AU - Gervas, Reginald
AU - Kibuuka, Hannah
AU - Maswai, Jonah
AU - Singoei, Valentine
AU - Iroezindu, Michael
AU - Fasina, Abiola
AU - Esber, Allahna
AU - Dear, Nicole
AU - Imbach, Michelle
AU - Crowell, Trevor A.
AU - Hern, Jaclyn
AU - Song, Xiaofang
AU - Hoelscher, Michael
AU - Polyak, Christina S.
AU - Ake, Julie A.
AU - Geldmacher, Christof
N1 - Funding Information:
Funding: this work was supported by the Military HIV Research Program and the President's Emergency Plan for AIDS Relief (PEPFAR) via cooperative agreements between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the U.S. Department of Defense (W81XWH-11-2-0174 and W81XWH-18-2-0040). The views expressed are those of the authors and should not be construed to represent the positions of the US Army or the Department of Defense. Optimization of high-risk HPV genotyping needed for the study was supported by Deutsche Forschungsgemeinschaft (reference number; 2128/2-1 and 2128/2-2, Project number 620615). Write-up of this work was partly supported by University of Dar es Salaam's ‘Female Leaders Academic Publishing Support Programme (FLAPS) 2022/1’. The investigators have adhered to the policies for protection of human subjects as prescribed in AR 70-25.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/3/15
Y1 - 2023/3/15
N2 - Objective:Cervical cancer is a common preventable cancer among African women living with HIV (WLWH). Molecular diagnostics for high-risk human papillomavirus (HR-HPV) genotypes are standard components of cervical cancer screening in resource-rich countries but not in resource-limited settings. We evaluated HR-HPV genotypes among women with and without HIV in four African countries to inform cervical cancer preventive strategies.Methods:The African Cohort Study (AFRICOS) enrolled participants with and without HIV at 12 clinics in Tanzania, Kenya, Uganda, and Nigeria. Cervical cytobrush specimens from women were genotyped for 14 HR-HPV types using the multiplex Seegene Anyplex real-time PCR assay. Robust Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with HR-HPV in WLWH.Results:From January 2015 to March 2020, 868 WLWH and 134 women living without HIV (WLWoH) were tested for HR-HPV with prevalence of 50.9 and 38.1%, respectively (P = 0.007). Among WLWH, 844 (97.4%) were antiretroviral therapy (ART)-experienced and 772 (89.7%) virally suppressed 1000 copies/ml or less. The most frequent HR-HPV types among WLWH were HPV-16 (13.5%), HPV-52 (9.5%), and HPV-35 (9.3%). HR-HPV infection was more common among Tanzanian WLWH (adjusted RR: 1.23, 95% CI 1.05-1.44, P = 0.012). Also, WLWH with CD4+T cells of less than 200 cell/μl had 1.51-fold increased risk of having HR-HPV (95% CI 1.23-1.86, P < 0.001).Conclusion:HR-HPV was common in WLWH in four African countries, particularly among women with low CD4+cell count. Scale up of HPV vaccines and development of vaccines with broader activity against less common HR-HPV types may improve cervical cancer prevention in Africa.
AB - Objective:Cervical cancer is a common preventable cancer among African women living with HIV (WLWH). Molecular diagnostics for high-risk human papillomavirus (HR-HPV) genotypes are standard components of cervical cancer screening in resource-rich countries but not in resource-limited settings. We evaluated HR-HPV genotypes among women with and without HIV in four African countries to inform cervical cancer preventive strategies.Methods:The African Cohort Study (AFRICOS) enrolled participants with and without HIV at 12 clinics in Tanzania, Kenya, Uganda, and Nigeria. Cervical cytobrush specimens from women were genotyped for 14 HR-HPV types using the multiplex Seegene Anyplex real-time PCR assay. Robust Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with HR-HPV in WLWH.Results:From January 2015 to March 2020, 868 WLWH and 134 women living without HIV (WLWoH) were tested for HR-HPV with prevalence of 50.9 and 38.1%, respectively (P = 0.007). Among WLWH, 844 (97.4%) were antiretroviral therapy (ART)-experienced and 772 (89.7%) virally suppressed 1000 copies/ml or less. The most frequent HR-HPV types among WLWH were HPV-16 (13.5%), HPV-52 (9.5%), and HPV-35 (9.3%). HR-HPV infection was more common among Tanzanian WLWH (adjusted RR: 1.23, 95% CI 1.05-1.44, P = 0.012). Also, WLWH with CD4+T cells of less than 200 cell/μl had 1.51-fold increased risk of having HR-HPV (95% CI 1.23-1.86, P < 0.001).Conclusion:HR-HPV was common in WLWH in four African countries, particularly among women with low CD4+cell count. Scale up of HPV vaccines and development of vaccines with broader activity against less common HR-HPV types may improve cervical cancer prevention in Africa.
KW - AIDS
KW - Africa
KW - HIV
KW - antiretroviral therapy
KW - high-risk human papilloma virus
KW - uterine cervical neoplasms
KW - women living with HIV
UR - http://www.scopus.com/inward/record.url?scp=85148678916&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000003437
DO - 10.1097/QAD.0000000000003437
M3 - Article
C2 - 36398743
AN - SCOPUS:85148678916
SN - 0269-9370
VL - 37
SP - 625
EP - 635
JO - AIDS
JF - AIDS
IS - 4
ER -