title: Human papillomavirus in a rural community in Zimbabwe: the impact of HIV co-infection on HPV genotype distribution.
abstract: Cervical cancer is a leading cause of cancer-related deaths in developing countries, and the human papillomavirus (HPV) is linked etiologically to cervical cancer. Hence, a vaccine which prevents HPV-associated cervical cancer would have the most impact in developing countries, including the African continent. The type-specific immune response towards HPV virus-like particles, in combination with geographical variation in the prevalence of HPV, necessitates the presence of multiple HPV type antigens in a single vaccine cocktail in order to provide relevant protection. We aimed to investigate whether co-infection with HIV, which is highly prevalent in Africa, plays a role in HPV genotype distribution. After informed consent, HPV detection by GP5+/6+ PCR and HIV detection by serology was carried out on 236 women from the rural north-western part of Zimbabwe. The prevalence of HPV was higher in HIV positive women (54%) than in HIV negative women (27%). Certain HPV types (HPV types 11, 39, 43, 51, and 59, P-values ranging from 0.017 to 0.067) occurred more frequently in HIV positive women. Only high-risk HPV, and not HIV, was associated significantly with cervical intraepithelial neoplasia in multiple regression analysis. In conclusion, a high prevalence of HPV was found in a rural community, where regular Papanicolaou (Pap) smears would be a logistic and economic impossibility, but where free vaccination programmes against other infections are already established. The results suggest that HIV co-infection may have an impact on HPV genotype distribution.
authors.affiliation: Department of Medical Oncology, University of Antwerp, Antwerp, Belgium. Marc.Baay@ua.ac.be
authors.forename: Marc F D
authors.initials: MF
authors.lastname: Baay
authors.forename: Eyrun F
authors.initials: EF
authors.lastname: Kjetland
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Ndhlovu
authors.forename: Vanessa
authors.initials: V
authors.lastname: Deschoolmeester
authors.forename: Takafira
authors.initials: T
authors.lastname: Mduluza
authors.forename: Exenevia
authors.initials: E
authors.lastname: Gomo
authors.forename: Henrik
authors.initials: H
authors.lastname: Friis
authors.forename: Nicholas
authors.initials: N
authors.lastname: Midzi
authors.forename: Lovemore
authors.initials: L
authors.lastname: Gwanzura
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mason
authors.forename: Jan B
authors.initials: JB
authors.lastname: Vermorken
authors.forename: Svein G
authors.initials: SG
authors.lastname: Gundersen
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005838:Genotype; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D002583:Uterine Cervical Neoplasms / Q000821:virology; D014621:Vagina / Q000821:virology; D044364:Vaginal Douching; D015030:Zimbabwe / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000821:virology
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies