title: Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women.
abstract: BACKGROUND
  Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection.
  
  
  RESULTS
  79 out of 215 (36.7%) enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%). The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3). Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases.
  
  
  CONCLUSIONS
  In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes.
authors.affiliation: Department of Community and Family Medicine, and Program of Cancer Detection, Prevention and Control, Duke University School of Medicine, Durham, NC, USA. cathrine.hoyo@duke.edu.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Vidal
authors.forename: Susan K
authors.initials: SK
authors.lastname: Murphy
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.forename: Brandi
authors.initials: B
authors.lastname: Vasquez
authors.forename: John A
authors.initials: JA
authors.lastname: Bartlett
authors.forename: Olola
authors.initials: O
authors.lastname: Oneko
authors.forename: Pendo
authors.initials: P
authors.lastname: Mlay
authors.forename: Joseph
authors.initials: J
authors.lastname: Obure
authors.forename: Francine
authors.initials: F
authors.lastname: Overcash
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Mike
authors.initials: M
authors.lastname: van der Kolk
authors.forename: Cathrine
authors.initials: C
authors.lastname: Hoyo
references.citation: Br J Cancer. 2005 Oct 31;93(9):1068-76
references.pmid: 16106268
references.citation: Int J Cancer. 2004 Aug 20;111(2):278-85
references.pmid: 15197783
references.citation: J Clin Pathol. 2002 Apr;55(4):244-65
references.pmid: 11919208
references.citation: Int J Cancer. 1998 May 18;76(4):480-6
references.pmid: 9590121
references.citation: Int J Cancer. 1992 Jun 19;51(4):515-21
references.pmid: 1318265
references.citation: Lancet Oncol. 2009 Apr;10(4):321-2
references.pmid: 19350698
references.citation: Int J Cancer. 2010 Dec 15;127(12):2893-917
references.pmid: 21351269
references.citation: J Gen Virol. 1999 Feb;80 ( Pt 2):409-417
references.pmid: 10073701
references.citation: J Natl Cancer Inst Monogr. 2003;(31):3-13
references.pmid: 12807939
references.citation: Int J Cancer. 2007 Aug 1;121(3):621-32
references.pmid: 17405118
references.citation: J Infect Dis. 2001 Jan 1;183(1):8-15
references.pmid: 11087198
references.citation: Alaska Med. 1999 Oct-Dec;41(4):76-85
references.pmid: 10710795
references.citation: Int J Cancer. 2007 Dec 15;121(12):2682-7
references.pmid: 17724723
references.citation: Am Fam Physician. 2003 Nov 15;68(10):1992-8
references.pmid: 14655809
references.citation: J Med Virol. 1996 Aug;49(4):259-63
references.pmid: 8877756
references.citation: Trop Med Int Health. 2009 Oct;14(10):1287-302
references.pmid: 19772550
references.citation: Sex Transm Dis. 2003 Feb;30(2):137-42
references.pmid: 12567172
references.citation: Lancet Infect Dis. 2007 Jul;7(7):453-9
references.pmid: 17597569
references.citation: J Clin Microbiol. 2008 Dec;46(12):3946-51
references.pmid: 18923015
references.citation: Br J Cancer. 2006 Aug 7;95(3):355-62
references.pmid: 16832413
references.citation: Cancer Detect Prev. 2005;29(4):307-16
references.pmid: 16122882
references.citation: J Clin Microbiol. 2003 Sep;41(9):4451-3
references.pmid: 12958291
references.citation: Int J Cancer. 2002 Aug 20;100(6):729-32
references.pmid: 12209615
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Jul;17(7):1611-22
references.pmid: 18628412
references.citation: Int J Epidemiol. 2002 Feb;31(1):202-9
references.pmid: 11914322
references.citation: Int J Gynecol Cancer. 2004 Sep-Oct;14(5):751-61
references.pmid: 15361181
references.citation: J Microbiol. 2004 Dec;42(4):255-66
references.pmid: 15650698
references.citation: Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1675-81
references.pmid: 20615885
references.citation: J Med Virol. 2011 Jun;83(6):1034-41
references.pmid: 21503917
references.citation: Lancet. 2001 Oct 27;358(9291):1429-30
references.pmid: 11705494
references.citation: Int J Cancer. 1998 Oct 29;78(3):281-5
references.pmid: 9766558
references.citation: J Pathol. 1999 Sep;189(1):12-9
references.pmid: 10451482
references.citation: Br J Cancer. 2003 Jan 13;88(1):63-73
references.pmid: 12556961
references.citation: J Med Virol. 2003 Oct;71(2):265-73
references.pmid: 12938202
references.citation: J Clin Virol. 2005 Mar;32 Suppl 1:S16-24
references.pmid: 15753008
references.citation: Am J Obstet Gynecol. 1998 Jun;178(6):1235-44
references.pmid: 9662307
references.citation: Vaccine. 2008 Aug 19;26 Suppl 10:K29-41
references.pmid: 18847555