Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status.
BACKGROUND
Both cervical cancer and human immunodeficiency virus (HIV) are major public health problems in Sub-Saharan Africa. The objectives of the study were to investigate human papillomavirus (HPV) prevalence according to age, HIV status and gender.


METHODS
Participants were 208 HIV-negative women, 278 HIV-positive women, 325 HIV-negative men and 161 HIV-positive men between the ages of 18-66 years. HPV types were determined in cervical and penile cells by Roche Linear Array HPV genotyping assay.


RESULTS
HPV prevalence was 36.7 % (76/207; 95 % confidence intervals (CI): 30.4-43.4 %) in HIV-negative women, with the highest prevalence of 61.0 % (25/41; 95 % CI: 45.7-74.4 %) in women aged 18-25 years. HPV prevalence was 74.0 % (205/277; 95 % CI: 68.5-78.8 %) in HIV-positive women, with the highest prevalence of 86.4 % (38/44; 95 % CI: 72.9-94.0 %) in women aged 18-25 years. HPV prevalence was found to decrease with increasing age in HIV-negative women (P = 0.0007), but not in HIV-positive women (P = 0.898). HPV prevalence was 50.8 % (159/313; 95 % CI: 45.3-56.3 %) in HIV-negative men, with the highest prevalence of 77.0 % (27/35; 95 % CI: 60.7-88.2 %) in men aged 18-25 years. HPV prevalence was 76.6 % (121/158; 95 % CI: 69.2-82.9 %) in HIV-positive men, with the highest prevalence of 87.5 % (7/8; 95 % CI: 50.8-99.9 %) in men 18-25 years of age. HPV prevalence was found to decrease with increasing age in HIV-negative men (P = 0.004), but not in HIV-positive men (P = 0.385). HIV-positive women had a significantly higher prevalence of one or more HPV type(s) in the bivalent (HPV-16/18: 20 % 55/277, 9 % 12/207; P <0.001), quadrivalent (HPV-6/11/16/18: 26 % 71/277, 12 % 24/207; P = 0.001) and nonavalent vaccine (HPV-6/11/16/18/31/33/52/56/58: 65 % 181/277, 24 % 50/207; P <0.001) compared to HIV-negative women. Similar observation were observed in men for bivalent (20 % 32/158, 10 % 30/313; P = 0.001), quadrivalent (35 % 56/158, 13 % 41/313; P <0.001) and nonavalent vaccine (75 % 119/158, 28 % 87/313; P <0.001).


CONCLUSIONS
This study demonstrated high HPV prevalence among HIV-positive women and men in all age groups. The high prevalence of HPV types found in bivalent, quadrivalent and nonavalent vaccines in South African HIV-positive and HIV-negative women and men demonstrate that this population will greatly benefit from current HPV vaccines.
Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, University of Cape Town, Anzio Road, Observatory, 7925, Cape Town, South Africa. Zizipho.Mbulawa@uct.ac.za.|Center for HIV and STIs, National Institute for Communicable Disease, National Health Laboratory Service, Cape Town, South Africa. Zizipho.Mbulawa@uct.ac.za.
Zizipho Z A
ZZ
Mbulawa
Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. David.Coetzee@uct.ac.za.
David
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Coetzee
Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, University of Cape Town, Anzio Road, Observatory, 7925, Cape Town, South Africa. Anna-Lise.Williamson@uct.ac.za.|SAMRC Gynaecological Cancer Centre, University of Cape Town, Cape Town, South Africa. Anna-Lise.Williamson@uct.ac.za.|National Health Laboratory Service, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa. Anna-Lise.Williamson@uct.ac.za.
Anna-Lise
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Williamson
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006679:HIV Seropositivity; D052162:Human papillomavirus 16 / Q000235:genetics / Q000472:pathogenicity; D052163:Human papillomavirus 6 / Q000276:immunology / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000821:virology; D055815:Young Adult