title: Age-specific prevalence of cervical human papillomavirus infection and cytological abnormalities in women in Gauteng Province, South Africa.
abstract: BACKGROUND
  Women accessing the public health system in Gauteng province, South Africa are largely unscreened for cervical cancer and have a high background prevalence of human immunodeficiency virus (HIV) infection.
  
  
  OBJECTIVE
  This cross-sectional study describes the age-specific prevalence of human papillomavirus (HPV) infection and cytological abnormalities among this urban and peri-urban population.
  
  
  METHODS
  Over the period March 2009 - September 2011, 1 524 women attending public sector primary healthcare clinics were invited to participate in a cervical cancer screening study. All participants were screened with conventional cytology and HPV testing undertaken using the HPV linear array genotyping kit (Roche Molecular Systems).
  
  
  RESULTS
  Of 1 472 women with valid cytology results, abnormalities were detected in 17.3% (n = 255), of which 9.1% (n = 134) were high-grade squamous intraepithelial lesions, and 0.5% (n = 8) suggestive of squamous carcinoma. Of the 1,445 women with complete data, the overall and high-risk HPV DNA prevalences were 74.6% (n = 1 078) and 54.3% (n = 784), respectively. HPV type 16 and/or 18 were detected in 19.5% (n = 282) of women. Age-specific prevalence of HPV showed a plateau-shaped curve.
  
  
  CONCLUSIONS
  The prevalences of HPV infection and abnormal cytology were much higher than previously reported in general populations in South Africa and elsewhere. Higher age-specific prevalence and similar plateau-like age-specific epidemiological curves have previously only been described in studies among HIV-positive women. These findings have implications for planning and development of cervical screening programmes in developing countries with largely unscreened populations with a high background prevalence of HIV.
authors: Department of Medical Virology, University of Pretoria, National Health Laboratory Service, Pretoria, South Africa. karin.richter@up.ac.za
authors: K
authors: K
authors: Richter
authors: P
authors: P
authors: Becker
authors: A
authors: A
authors: Horton
authors: G
authors: G
authors: Dreyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D011322:Primary Prevention; D055502:Secondary Prevention; D013019:South Africa / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology