PLoS ONE (Jan 2017)

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.

  • Helen A Kelly,
  • Jean Ngou,
  • Admire Chikandiwa,
  • Bernard Sawadogo,
  • Clare Gilham,
  • Tanvier Omar,
  • Olga Lompo,
  • Sylviane Doutre,
  • Nicolas Meda,
  • Helen A Weiss,
  • Sinead Delany-Moretlwe,
  • Michel Segondy,
  • Philippe Mayaud,
  • HARP Study Group

DOI
https://doi.org/10.1371/journal.pone.0174117
Journal volume & issue
Vol. 12, no. 3
p. e0174117

Abstract

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ObjectiveTo 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).MethodsProspective 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.ResultsAmong 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).ConclusionHR-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.