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

DOI
https://doi.org/10.3389/fonc.2021.763717
Journal volume & issue
Vol. 11

Abstract

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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.

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