Frontiers in Oncology (Nov 2021)
HPV Type Distribution in HIV Positive and Negative Women With or Without Cervical Dysplasia or Cancer in East Africa
- Ruby Mcharo,
- Tessa Lennemann,
- Tessa Lennemann,
- John France,
- Liseth Torres,
- Mercè Garí,
- Wilbert Mbuya,
- Wilbert Mbuya,
- Wolfram Mwalongo,
- Anifrid Mahenge,
- Asli Bauer,
- Asli Bauer,
- Jonathan Mnkai,
- Laura Glasmeyer,
- Mona Judick,
- Matilda Paul,
- Nicolas Schroeder,
- Bareke Msomba,
- Magreth Sembo,
- Nhamo Chiwerengo,
- Michael Hoelscher,
- Michael Hoelscher,
- Otto Geisenberger,
- Otto Geisenberger,
- Ralph J. Lelle,
- Elmar Saathoff,
- Elmar Saathoff,
- Leonard Maboko,
- Mkunde Chachage,
- Mkunde Chachage,
- Mkunde Chachage,
- Arne Kroidl,
- Arne Kroidl,
- Christof Geldmacher,
- Christof Geldmacher
Affiliations
- Ruby Mcharo
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Tessa Lennemann
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Tessa Lennemann
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- John France
- Department of Obstetrics and Gynecology, Mbeya Zonal Referral Hospital, Mbeya, Tanzania
- Liseth Torres
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Mercè Garí
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- Wilbert Mbuya
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Wilbert Mbuya
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Wolfram Mwalongo
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Anifrid Mahenge
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Asli Bauer
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Asli Bauer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Jonathan Mnkai
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Laura Glasmeyer
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Mona Judick
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Matilda Paul
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Nicolas Schroeder
- Institute for Pathology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Bareke Msomba
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Magreth Sembo
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Nhamo Chiwerengo
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Michael Hoelscher
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Otto Geisenberger
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Otto Geisenberger
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Ralph J. Lelle
- Department of Gynecology and Obstetrics, University of Muenster, Muenster, Germany
- Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Elmar Saathoff
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Leonard Maboko
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Mkunde Chachage
- National Institute for Medical Research (NIMR)-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- Mkunde Chachage
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Mkunde Chachage
- University of Dar es Salaam–Mbeya College of Health and Allied Sciences (UDSM-MCHAS), Mbeya, Tanzania
- Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Arne Kroidl
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- Christof Geldmacher
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- DOI
- https://doi.org/10.3389/fonc.2021.763717
- Journal volume & issue
-
Vol. 11
Abstract
BackgroundWomen living with HIV in sub-Saharan Africa are at increased risk to develop cervical cancer (CC), which is caused by persistent infection with 13 oncogenic human papilloma viruses (HR-HPVs). It is important to accurately identify and target HIV-positive women at highest risk to develop CC for early therapeutic intervention.MethodsA total of 2,134 HIV+ and HIV− women from South-West Tanzania were prospectively screened for cervical cancer and precancerous lesions. Women with cervical cancer (n=236), high- and low-grade squamous intraepithelial lesions (HSIL: n=68, LSIL: n=74), and without lesion (n=426) underwent high-resolution HPV genotyping.ResultsEighty percent of women who were diagnosed with HSIL or LSIL were living with HIV. Any lesion, young age, HIV status, and depleted CD4 T cell counts were independent risk factors for HPV infections, which were predominantly caused by HR-HPV types. While multiple HR-HPV type infections were predominant in HIV+ women with HSIL, single-type infections predominated in HIV+ CC cases (p=0.0006). HPV16, 18, and 45 accounted for 85% (68/80) and 75% (82/110) of HIV+ and HIV− CC cases, respectively. Of note, HPV35, the most frequent HPV type in HSIL-positive women living with HIV, was rarely detected as a single-type infection in HSIL and cancer cases.ConclusionHPV16, 18, and 45 should receive special attention for molecular diagnostic algorithms during CC prevention programs for HIV+ women from sub-Saharan Africa. HPV35 may have a high potential to induce HSIL in women living with HIV, but less potential to cause cervical cancer in single-type infections.
Keywords
- human papilloma virus—HPV
- human immunodeficiency virus—HIV
- cervical cancer
- cervical dysplasia
- high-grade intraepithelial lesions
- low-grade intraepithelial lesions