1. Human Papillomavirus Genotypes in Invasive Cervical Carcinoma in HIV-Seropositive and HIV-Seronegative Women in Zimbabwe
- Author
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Rudo Makunike-Mutasa, Martin Hale, Joel M. Palefsky, Fiona Mutisi, Washington Mudini, Alltalents T. Murahwa, Altini Mario, and Michael Chirenje
- Subjects
cervical cancer ,Hiv seropositive ,Human immunodeficiency virus (HIV) ,Uterine Cervical Neoplasms ,Alphapapillomavirus ,medicine.disease_cause ,Serology ,0302 clinical medicine ,Genotype ,Cervical carcinoma ,HIV Seropositivity ,Pharmacology (medical) ,030212 general & internal medicine ,Cancer ,Cervical cancer ,Obstetrics ,virus diseases ,Middle Aged ,Vaccination ,Infectious Diseases ,030220 oncology & carcinogenesis ,Public Health and Health Services ,HIV/AIDS ,Female ,Infection ,Adult ,Zimbabwe ,HPV ,medicine.medical_specialty ,Clinical Trials and Supportive Activities ,Clinical Sciences ,Article ,Vaccine Related ,03 medical and health sciences ,Clinical Research ,Virology ,HIV Seronegativity ,Genetics ,medicine ,Humans ,Neoplasm Invasiveness ,Human papillomavirus ,business.industry ,Prevention ,HIV ,medicine.disease ,Tumor Virus Infections ,Cross-Sectional Studies ,Sexually Transmitted Infections ,Immunization ,HPV and/or Cervical Cancer Vaccines ,dot-blot hybridization ,business - Abstract
BACKGROUND Invasive cervical carcinoma (ICC) accounts for 23% of all cancer-related deaths in Zimbabwean women. Trials for a national program of genotype-specific human papillomavirus (HPV) vaccines are underway to prevent cervical carcinoma, but the distribution of HPV types among women with ICC according to HIV status is unknown. METHODS To determine prevalence and distribution of high-risk HPV genotypes by HIV status in women with ICC, we performed a cross-sectional study on women referred for ICC testing at 4 urban referral hospitals in Zimbabwe from June 2014 to December 2015. Cervical biopsies were obtained for histology and HPV genotyping. HIV serology testing was performed. HPV testing was performed using MY09/MY11 polymerase chain reaction followed by typing using dot-blot hybridization. RESULTS Of 107 participants with histologically proven ICC, HIV prevalence was 49.5% (53/107). HIV-positive women tended to be younger (median age 44 years) than HIV-negative women (median age 59 years). HPV prevalence was 94% (101/107), ranging from 1 to 5 genotypes per participant. HPV 16 (81.5%), 18 (24%), 33 (13%), 35 (11%), 56 (9%), and 45 (7.4%) were the most prevalent genotypes among HIV-negative participants; HPV 16 (67.9%), 18 (43.4%), 56 (18.9%), 45 (15.1%), 33 (11.3%), and 58 (9.4%) were the most prevalent among HIV-positive participants. Eighty-three percent of women were infected with either HPV-16 or HPV-18. CONCLUSIONS Effective vaccination programs against HPV 16 and HPV 18 could prevent up to 83% of cases of cervical cancer in Zimbabwe. HIV may influence distribution of some HPV genotypes given the significant increase in prevalence of HPV 18 among HIV-positive participants.
- Published
- 2018