title: Distribution of high-risk human papillomavirus genotypes among HIV-negative women with and without cervical intraepithelial neoplasia in South Africa.
abstract: OBJECTIVE
  Large studies describing the profile of high-risk Human papillomavirus (hrHPV) genotypes among women in sub-Saharan Africa are lacking. Here we describe the prevalence and distribution of hrHPV genotypes among HIV-negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN).
  
  
  METHODS
  We report data on 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies undertaken in Cape Town, South Africa. Women had no history of previous cervical cancer screening. Cervical samples were tested for hrHPV DNA using the Hybrid Capture 2 (HC2) assay and all positive samples were genotyped using a PCR-based assay (Line Blot). Women underwent colposcopy and biopsy/endocervical curettage to determine CIN status. The prevalence and distribution of specific hrHPV genotypes were examined by age and CIN status.
  
  
  RESULTS
  Overall, 20.7% (95% CI, 19.9-21.6%) of women were hrHPV-positive by HC2, with women with CIN having the highest rates of positivity. Prevalence decreased with increasing age among women without CIN; but, a bimodal age curve was observed among women with CIN. HPV 16 and 35 were the most common hrHPV genotypes in all age and CIN groups. HPV 45 became more frequent among older women with CIN grade 2 or 3 (CIN2,3). Younger women (17-29 years) had more multiple hrHPV genotypes overall and in each cervical disease group than older women (40-65 years).
  
  
  CONCLUSIONS
  HPV 16, 35, and 45 were the leading contributors to CIN 2,3. The current HPV vaccines could significantly reduce HPV-related cervical disease; however, next generation vaccines that include HPV 35 and 45 would further reduce cervical disease in this population.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America.
authors.forename: Alicia C
authors.initials: AC
authors.lastname: McDonald
authors.forename: Lynette
authors.initials: L
authors.lastname: Denny
authors.forename: Chunhui
authors.initials: C
authors.lastname: Wang
authors.forename: Wei-Yann
authors.initials: WY
authors.lastname: Tsai
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wright
authors.forename: Louise
authors.initials: L
authors.lastname: Kuhn
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D018023:HIV Seronegativity / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology*
chemical_list: D004279:DNA, Viral