title: The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda.
abstract: BACKGROUND
  The prevalence, incidence and persistence of human papillomavirus (HPV) types in sub-Saharan Africa are not well established. The objectives of the current study are to describe (predictors of) the epidemiology of HPV among high-risk women in Kigali, Rwanda.
  
  
  METHODS
  HIV-negative, high-risk women were seen quarterly for one year, and once in Year 2. HIV serostatus, clinical, and behavioral information were assessed at each visit, HPV types at Month 6 and Year 2, and other sexually transmitted infections (STI) at selected visits. HPV prevalence was also assessed in HIV-positive, high-risk women.
  
  
  RESULTS
  Prevalence of any HPV was 47.0% in HIV-negative women (median age 25 years) compared to 72.2% in HIV-positive women (median age 27 years; OR 2.9, 95% CI 1.9-4.6). Among HIV-negative women, cumulative incidence of high-risk (HR)-HPV was 28.0% and persistence 32.0% after a mean period of 16.6 and 16.9 months, respectively. Prior Chlamydia trachomatis and Neisseria gonorrhoeae infection, concurrent low-risk (LR)-HPV infection and incident HSV-2 were associated with HR-HPV prevalence among HIV-negative women; prior C. trachomatis infection and co-infection with LR-HPV and HPV16-related HPV types with HR-HPV acquisition. HPV16-related types were the most prevalent and persistent.
  
  
  CONCLUSIONS
  High HPV prevalence, incidence and persistence were found among high-risk women in Kigali. HPV52 had the highest incidence; and, together with HPV33 and HPV58, were strongly associated with acquisition of other HR-HPV types in HIV-negative women.
authors.affiliation: Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam Institute for Global Health and Development, the Netherlands. n.veldhuijzen@aighd.org
authors.forename: Nienke J
authors.initials: NJ
authors.lastname: Veldhuijzen
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Braunstein
authors.forename: Joseph
authors.initials: J
authors.lastname: Vyankandondera
authors.forename: Chantal
authors.initials: C
authors.lastname: Ingabire
authors.forename: Justin
authors.initials: J
authors.lastname: Ntirushwa
authors.forename: Evelyne
authors.initials: E
authors.lastname: Kestelyn
authors.forename: Coosje
authors.initials: C
authors.lastname: Tuijn
authors.forename: Ferdinand W
authors.initials: FW
authors.lastname: Wit
authors.forename: Aline
authors.initials: A
authors.lastname: Umutoni
authors.forename: Mireille
authors.initials: M
authors.lastname: Uwineza
authors.forename: Tania
authors.initials: T
authors.lastname: Crucitti
authors.forename: Janneke H H M
authors.initials: JH
authors.lastname: van de Wijgert
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012432:Rwanda / Q000453:epidemiology