title: High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination.
abstract: High-risk human papillomavirus (hr-HPV) infections and low-grade squamous intraepithelial lesions occur frequently in young women. The available vaccines cover up to seven hr-HPV genotypes (HPV16, HPV18, HPV31, HPV33, HPV45, HPV52 and HPV58) and two low-risk HPV types (HPV6 and HPV11). The objective of this study was to describe the hr-HPV genotypes present among HIV-uninfected and HIV-infected young women in rural high schools.
  
  
  
  Cervicovaginal lavages were obtained from sexually active young women recruited from high schools in KwaZulu-Natal (n = 1223). HPV testing was done by the polymerase chain reaction using GP5+/GP6 + primers and enzyme immunoassay. HIV testing was done using rapid test kits.
  
  
  
  Of the 1223 cervicovaginal lavages, 301 (25%) were positive for hr-HPV. The HPV prevalence was higher in HIV infected (32.20%, 95% CI: 0.27-0.38) than in HIV-uninfected women (22.50%, 95% CI: 0.21-0.26), (p = .001). Similarly, multiple infections were slightly more common in HIV infected (59.32%) than in HIV-uninfected women (53.51%), (p = .37). The nine predominant genotypes in descending order were HPV types 16 (n = 99, 22.10%), 51 (n = 58, 12.91%), 18 (n = 56, 12.50%), 35 (n = 50, 11.10%), 33 (n = 47, 10.82%), 56 (n = 42, 9.31%), 45 (n = 34, 7.60%), 52 (n = 32, 7.14%) and 59 (n = 31, 6.91%). HPV 35, 51, 56 and 59 (40.62%), which are not covered by any vaccine, were among the most prevalent in the schools of KwaZulu-Natal.
  
  
  
  Four of the most predominant high-risk HPV types in this region are not covered by the new nine-valent HPV vaccine.
authors.affiliation: a Department of Infection, Prevention and Control , University of KwaZulu-Natal, School of Laboratory Medicine and Medical Science , Durban , South Africa.|b Department of Biomedical and Clinical Technology , Durban University of Technology , Durban , South Africa.
authors.forename: Joyce N
authors.initials: JN
authors.lastname: Mbatha
authors.affiliation: c Discipline of Public Health , Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban , South Africa.
authors.forename: Myra
authors.initials: M
authors.lastname: Taylor
authors.affiliation: d Department of Infectious Diseases , Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital , Oslo , Norway.|e Faculty of Medicine , University of Oslo , Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kleppa
authors.affiliation: d Department of Infectious Diseases , Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital , Oslo , Norway.
authors.forename: Kristine
authors.initials: K
authors.lastname: Lillebo
authors.affiliation: d Department of Infectious Diseases , Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital , Oslo , Norway.|e Faculty of Medicine , University of Oslo , Norway.
authors.forename: Hashini N
authors.initials: HN
authors.lastname: Galappaththi-Arachchige
authors.affiliation: f Department of Physics , Durban University of Technology , Durban , South Africa.
authors.forename: Deepak
authors.initials: D
authors.lastname: Singh
authors.affiliation: c Discipline of Public Health , Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban , South Africa.|d Department of Infectious Diseases , Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital , Oslo , Norway.|e Faculty of Medicine , University of Oslo , Norway.
authors.forename: Eyrun F
authors.initials: EF
authors.lastname: Kjetland
authors.affiliation: d Department of Infectious Diseases , Norwegian Centre for Imported and Tropical Diseases, Oslo University Hospital , Oslo , Norway.|g University of Antwerp , Laboratory of Cancer Research and Clinical Oncology , Antwerp , Belgium.
authors.forename: Marc F D
authors.initials: MFD
authors.lastname: Baay
authors.affiliation: a Department of Infection, Prevention and Control , University of KwaZulu-Natal, School of Laboratory Medicine and Medical Science , Durban , South Africa.|h Department of Biomedical Sciences , Mangosuthu University of Technology , Faculty of Natural Sciences , Durban , South Africa.
authors.forename: Zilungile L
authors.initials: ZL
authors.lastname: Mkhize-Kwitshana
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology*; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D053918:Papillomavirus Vaccines; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D014621:Vagina / Q000821:virology; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human papillomavirus; cervical cancer; human immunodeficiency virus