Associations of Human Papillomavirus (HPV) genotypes with high-grade cervical neoplasia (CIN2+) in a cohort of women living with HIV in Burkina Faso and South Africa

• Published in: PloS one 2017-03, Vol.12 (3), p.e0174117-e0174117
• Main Authors: Kelly, Helen A, Ngou, Jean, Chikandiwa, Admire, Sawadogo, Bernard, Gilham, Clare, Omar, Tanvier, Lompo, Olga, Doutre, Sylviane, Meda, Nicolas, Weiss, Helen A, Delany-Moretlwe, Sinead, Segondy, Michel, Mayaud, Philippe
• Format: Article
• Language: English
• Subjects: Adult; Biology and Life Sciences; Biopsy; Birth control; Burkina Faso - epidemiology; Cancer; Cervical cancer; Cervix Uteri - pathology; Cervix Uteri - virology; Chlamydia; Drug therapy; Epidemiology; Female; Genotype; Genotypes; Genotyping; Gynecology and obstetrics; HIV; HIV Infections - complications; HIV Infections - epidemiology; Hospitals; Human health and pathology; Human immunodeficiency virus; Human papillomavirus; Humans; Hygiene; Infections; Infectious diseases; Laboratories; Lentivirus; Life Sciences; Medical screening; Medicine; Medicine and Health Sciences; Papillomaviridae; Papillomaviridae - genetics; Papillomavirus Infections - complications; Papillomavirus Infections - virology; Papillomavirus Vaccines - therapeutic use; Population; Prevalence; Prospective Studies; Reproductive health; Research and Analysis Methods; Retroviridae; Santé publique et épidémiologie; South Africa - epidemiology; Systematic review; Trichomonas vaginalis; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - etiology; Uterine Cervical Neoplasms - pathology; Vaccines; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0174117

To describe associations of high-risk human papillomavirus (HR-HPV) with high-grade cervical intraepithelial neoplasia (CIN2+) in women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA). Prospective cohort of WLHIV attending HIV outpatient clinics and treatment centres. Recruitment was stratified by ART status. Cervical HPV genotyping using INNO-LiPA and histological assessment of 4-quadrant cervical biopsies at enrolment and 16 months later. Among women with CIN2+ at baseline, the prevalence of any HR-HPV genotypes included in the bi/quadrivalent (HPV16/18) or nonavalent (HPV16/18/31/35/45/52/58) HPV vaccines ranged from 37% to 90%. HPV58 was most strongly associated with CIN2+ (aOR = 5.40, 95%CI: 2.77-10.53). At 16-months follow-up, persistence of any HR-HPV was strongly associated with incident CIN2+ (aOR = 7.90, 95%CI: 3.11-20.07), as was persistence of HPV16/18 (aOR = 5.25, 95%CI: 2.14-12.91) and the additional HR types in the nonavalent vaccine (aOR = 3.23, 95%CI: 1.23-8.54). HR-HPV persistence is very common among African WLHIV and is linked to incident CIN2+. HPV vaccines could prevent between 37-90% of CIN2+ among African WLHIV.