The effects of genital schistosoma haematobium on human papillomavirus and the development of cervical neoplasia after five years in a Zimbabwean population.
BACKGROUND
High-risk human papillomavirus (HPV) is responsible for cervical cancer and genital Schistosoma haematobium infection has been hypothesized to be an additional co-factor or even an independent risk factor for cervical neoplasia. The present study aimed to investigate the impact of schistosomiasis on HPV persistence and development of cell atypia in a group of rural Zimbabwean women with confirmed high-risk HPV.


METHODS
A five-year follow-up was done among women previously included in a study on genital schistosomiasis. Women who had high-risk HPV at baseline were invited after 5 years for examination of cell atypia, genital schistosomiasis, and high-risk HPV. Both vaginal lavage samples (low-cost) and cervix brush samples (high-cost) were obtained for further analysis.


RESULTS
Thirty-seven women were re-examined. Genital Schistosoma haematobium of a minimum of five years' duration was associated with the development high-grade squamous intraepithelial neoplasia, but not with persistent high-risk HPV. There was a high concordance between the brush and vaginal lavage (96.3% agreement, kappa 0.93); however, the number of beta-globin negative vaginal lavage samples was unacceptably high.


CONCLUSIONS
Findings warrant an exploration in a larger longitudinal study where a vaginal swab should be explored.
Centre for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevaal University Hospital, Oslo, Norway.
E F
EF
Kjetland
P D
PD
Ndhlovu
T
T
Mduluza
V
V
Deschoolmeester
N
N
Midzi
E
E
Gomo
L
L
Gwanzura
P R
PR
Mason
J B
JB
Vermorken
H
H
Friis
S G
SG
Gundersen
M F D
MF
Baay
D000328:Adult; D000818:Animals; D016009:Chi-Square Distribution; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D012548:Schistosoma haematobium; D012553:Schistosomiasis haematobia / Q000150:complications* / Q000453:epidemiology; D014626:Vaginal Smears; D015030:Zimbabwe / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000209:etiology* / Q000821:virology