title: High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects.
abstract: OBJECTIVE
  We measured the prevalence and incidence of human papillomavirus (HPV) infection in young female subjects recruited for a safety and immunogenicity trial of the bivalent HPV-16/18 vaccine in Tanzania.
  
  
  METHODS
  Healthy HIV negative female subjects aged 10-25 years were enrolled and randomised (2:1) to receive HPV-16/18 vaccine or placebo (Al(OH)3 control). At enrolment, if sexually active, genital specimens were collected for HPV DNA, other reproductive tract infections and cervical cytology. Subjects were followed to 12 months when HPV testing was repeated.
  
  
  RESULTS
  In total 334 participants were enrolled; 221 and 113 in vaccine and control arms, respectively. At enrolment, 74% of 142 sexually active subjects had HPV infection of whom 69% had >1 genotype. Prevalent infections were HPV-45 (16%), HPV-53 (14%), HPV-16 (13%) and HPV-58 (13%). Only age was associated with prevalent HPV infection at enrolment. Among 23 girls who reported age at first sex as 1 year younger than their current age, 15 (65.2%) had HPV infection. Of 187 genotype-specific infections at enrolment, 51 (27%) were present at 12 months. Overall, 67% of 97 sexually active participants with results at enrolment and 12 months had a new HPV genotype at follow-up. Among HPV uninfected female subjects at enrolment, the incidence of any HPV infection was 76 per 100 person-years.
  
  
  CONCLUSIONS
  Among young women in Tanzania, HPV is highly prevalent and acquired soon after sexual debut. Early HPV vaccination is highly recommended in this population.
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK. deborah.watson-jones@lshtm.ac.uk
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.forename: Joelle
authors.initials: J
authors.lastname: Brown
authors.forename: Bazil
authors.initials: B
authors.lastname: Kavishe
authors.forename: Aura
authors.initials: A
authors.lastname: Andreasen
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.forename: Philippe
authors.initials: P
authors.lastname: Mayaud
authors.forename: Saidi
authors.initials: S
authors.lastname: Kapiga
authors.forename: Balthazar
authors.initials: B
authors.lastname: Gumodoka
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hayes
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
mesh_terms: D000293:Adolescent; D000917:Antibody Formation / Q000276:immunology; D002648:Child; D004311:Double-Blind Method; D005260:Female; D052161:Human papillomavirus 18 / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D008403:Mass Screening; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000276:immunology*; D015995:Prevalence; D060737:Reproductive Tract Infections / Q000453:epidemiology* / Q000276:immunology; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013636:Tanzania / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: AFRICA; HPV; SEROPREVALENCE